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New research shows how blood sugar-regulating cells change in type 2 diabetes

A person injecting insulin. Photo: iStock
Type 2 diabetes is the most common form of diabetes and accounts for the largest increase. In Sweden, around 600,000 people have diabetes. Of these, about 85–90 percent have type 2 diabetes. Photo: iStock

Researchers at Lund University in Sweden have carried out the most detailed mapping to date of the epigenome in the cells that regulate the body’s blood sugar levels. The study, published in Nature Metabolism, shows how chemical changes to DNA affect both insulin-producing beta cells and glucagon-producing alpha cells – and how these patterns change in type 2 diabetes.

All cells in the body have the same set of genes, but use different genes to develop into different types of cells. The epigenome controls this process by activating and deactivating cell type-specific genes. The hormones that regulate blood sugar, insulin and glucagon, are produced by cells in the pancreas. Insulin, which lowers blood sugar, is produced in the pancreas’s beta cells, whilst glucagon, which raises blood sugar, is produced in alpha cells. When the balance between the two hormones is disrupted, the risk of high blood sugar levels, and in the long run type 2 diabetes, increases.

Mapping epigenetic patterns in diabetes

By analysing hundreds of thousands of such cells from 24 people, both with and without diabetes, researchers in Lund were able to map how epigenetic patterns control gene activity in the cells and how this changes in diabetes. The results show how epigenetic changes affect the cells that regulate blood sugar, and how these changes differ between people with and without type 2 diabetes. This mapping study is the first of its kind. 

“It has made it possible, for the first time, to describe detailed, cell-specific epigenetic patterns. The study shows that many genes central to insulin and glucagon production are regulated by differences in DNA methylation,” says Charlotte Ling, Professor of Epigenetics at Lund University and the lead author of the study.

DNA methylation and gene regulation

DNA methylation is an epigenetic process in which small chemical groups are attached to DNA to control how the cell’s genes are used, without changing the actual DNA sequence. To see if they could influence the genes in the insulin-producing cells themselves, the researchers altered the DNA methylation near the genes for insulin and glucagon. This part of the study was carried out on cultured beta cells.

The researchers behind the study: Charlotte Ling, Jones Ofori, Sabrina Ruhrmann and Karl Bacos. Photo: Petra Olsson
The researchers behind the study: Charlotte Ling, Jones Ofori, Sabrina Ruhrmann and Karl Bacos. Photo: Petra Olsson

“Here, for the first time, we show exactly which regions regulate insulin and glucagon production through DNA methylation, which gives us the opportunity to develop future treatments based on epigenetics,” says Charlotte Ling.    

A particularly important finding in the study concerned a specific transcription factor – a protein that tells the cell which genes to use and in what quantities. The transcription factor ONECUT2 was found to be epigenetically elevated in beta cells from people with type 2 diabetes. Elevated levels of ONECUT2 impaired the beta cells’ energy production and their ability to release insulin – a mechanism that may contribute to the development of the disease.

“This gives us a deeper understanding of why beta cells lose their function in diabetes. In the longer term, this knowledge could help us identify new, personalised treatment targets,” says Charlotte Ling.

If epigenetic changes can be controlled to some extent, this could pave the way for future treatments that target the cell types affected by diabetes.  

“We now want to understand which of these changes can actually be reversed, and whether this can help beta cells regain their function in diabetes. A key aspect is to see whether the effects of editing DNA methylation can be sustained in the cell over time,” says Charlotte Ling. 

 

Contact

Charlotte Ling. Photo: Kennet Ruona

Charlotte Ling, professor of Epigenetics at Lund University and the lead author of the study

charlotte [dot] ling [at] med [dot] lu [dot] se (charlotte[dot]ling[at]med[dot]lu[dot]se)

+46–706 145 146

Profile in Lund University Research Portal 

Publication

Cell-specific DNA methylation in human alpha and beta cells regulates gene expression in type 2 diabetes, Nature Metabolism, 2026

DOI: 10.1038/s42255-026-01498-9

Funding

The Swedish research council, ERC, NNF, ALF, The Swedish diabetes foundation and Fysiografiska stiftelsen

The study in brief

Basic research // Peer-reviewed publication // Quantitative study // Researcher-initiated study // Cause-and-effect relationship // Statistical associations // In vitro // In vivo // Ex vivo // Cross-sectional study // Cohort study // Number of groups in the study: 2 // Number of patients in the study: 7 of 24 // Patient group(s): prediabetes type 2 + type 2 diabetes