Researcher from the Network: Daniel Espes

“As researchers, I think that we need to be creative. We must be able to think in new ways and to apply knowledge from other fields – to a large extent, research is about searching out what is still unknown. Another important quality is persistence. Behind every result lies large amounts of work, and in the beginning of my career I found this rather frustrating. You can easily work for a whole year with different trials without having anything to present in the end. This is where researchers must persevere and take aim at the goal further ahead.”

Daniel Espes is a Medical Doctor, Associate Senior Lecturer, and Assistant Professor focusing on type 1 diabetes research. He specialises in visualisation techniques and new treatment methods. In the Autumn of 2021, he was granted the means to form his own research group through SciLifeLab (‘Science for Life Laboratory’).  The same year, Espes was among those who received the most funding from Barndiabetesfonden – Sweden’s foremost financier of type 1 diabetes research. During this year, he also received the foundation’s Johny Ludvigsson Prize for ‘Younger Child Diabetes Researcher in Sweden’. Joining the Uppsala Diabetes Centre network felt like a natural step as he had been performing both research and clinical work for quite some time. For him, the UDC is an important way of bringing together the clinical and experimental aspects of the diabetes field. He is largely engaged with translational research in which results from experiments are applied to health care and clinical research.

Visualising and Treating Diabetes

Currently, Daniel Espes is working with new ways of utilizing so-called PET technology for diabetes research. The method is based on specific elements – ‘markers’ or ‘tracers’ – binding to known molecules or substances in a cell. The markers emit a small amount of radiation visible to instruments. When combined with X-ray, PET technologies can help localise very specific cells in the body.

“We are looking for markers that are taken up by insulin-producing beta cells, and separate markers for immune cells. If successful, we will be able to study how many beta cells exist in the pancreas and, for example, how that number is affected throughout the course of disease. Also, we could learn more about the process of immune attacks in the pancreas which will be addressed in an upcoming study. Previously, we have had to go on biopsies and measurements of immune cells in patients’ blood. Now, the question becomes whether we will be able to correlate PET results with what happens in the blood stream. Autopsies have taught us that by the time of diagnosis, between 60 to 70 per cent of the beta cell mass has already been lost. With the help of visualisation technologies, we may be able to identify those who are at risk of falling ill with type 1 diabetes at an earlier stage. It could be a question of siblings to children who carry the disease, or people who are known to have antigens which is a risk indicator,” says Daniel Espes.

Apart from working with visualization techniques, Daniel Espes is interested in new diabetes treatments. In an ongoing, clinical study, Espes and colleagues evaluate whether medicine containing the amino acid GABA can stimulate beta cells to reproduce, and if they can reduce the risk of autoimmune attacks.

“It is what experimental studies have shown. Some data also implies that GABA can make other endocrine cells produce insulin, but such results are more controversial. Now, we would like to find out whether the same effects occur in humans. We use GABA as an active substance in medicine given to subjects with type 1 diabetes. In the first phase of the study, GABA has been shown to improve hormonal protection against low blood sugar – in other words, the substance appears to have a partly protecting function. We are now at phase 2 – the main study which involves 36 patients. Here, we explore whether GABA can also increase insulin production. We hope to complete this study during the second half of 2022,” says Daniel Espes.

New Collaborations

In addition to the ongoing research on beta cells and new therapies, Daniel Espes is also very interested in how treatments can be improved for those who already live with diabetes. As such, he has worked with various research projects studying how AI and machine learning may improve the use of all the data being generated by continuous glucose monitors. In 2019, this work led him to co-found a company – Digital Diabetes Analytics.

“Our goal is to make life easier for those living with diabetes and improve diabetes care. We aim to do this by making use of all the data that is being generated and automating the interpretation of such information. Today’s healthcare has very limited resources when it comes to handling diabetes data. Therefore, most of the current data interpretation is being done manually. From this aspect, AI and machine learning have great potential to fundamentally change healthcare – not least when it comes to diabetes.”

The digital handling of large amounts of data and unknown variables is a growing field that requires technical expertise. Daniel Espes believes that the UDC will become an important forum to gather researchers from different backgrounds and with different approaches to diabetes. The research centre also signals a certain focus: When a field becomes so clearly prioritized, it becomes easier to attract interest and researchers.

“Diabetes research has so many levels – cell biology, physiology, technology, society, clinical aspects, and the individual. As such, it is very exciting to work in Uppsala. Here we can combine the expertise of many different fields and gather around a common issue. Previously, researchers have worked more separately, but the UDC is an example of new trends that prioritize collaboration. It is evident that diabetes as a subject spreads to new faculties. The scope of diabetes research has widened, and this opens for the formulation of brand-new questions which is very exciting.”

Anton Nyström

Photography: Hans Ericksson (modified)