On the diabetes treatment trail

WASHINGTON (CNN) -- Imagine a pediatrician diagnosing adult onset diabetes up to 50 years before symptoms appear -- and being able to prevent the disease from developing.

That's the potential promise of gene therapy, supporters like Dr. Alan Shuldiner say.

The body doesn't make insulin in type 1 diabetics. In type 2 diabetes, the body doesn't know how to properly use the insulin it makes. CNN NewsPass VIDEO CNN's Christy Feig takes a look at which teens are at risk for type 2 diabetes and why this disease is so dangerous for them (May 14) Play video

"What we're trying to do in this laboratory is to try and figure out what is different genetically in people with diabetes," Shuldiner said.

Shuldiner works in the Joslin Diabetes Center at the University of Maryland Medical Center. The diabetes research now underway there is also aimed at preventing type 1 -- or juvenile -- diabetes. This type affects 1 million Americans.

Joslin researchers say they are trying to get the body's cells that don't produce insulin to do just that. The search for a "switch" that would trigger insulin production is coupled with efforts to create other insulin pumps in the body.

"We're just trying to replace insulin, put it in a different tissue," says John McLenithan, also of Joslin.

By putting insulin into intestinal cells, researchers here hope to create a new insulin-producing tissue that turns on when you eat a meal.

It's been relatively easy to do in these genetically altered mice. And though research in people is still a ways down the road, scientists believe it will take a special virus to carry the insulin gene into cells inside the body.

"So, we're hoping to create a little insulin factory in the intestine," says McLenithan.

That's a big job, because first researchers have to understand just how the body's sensitivity to insulin is controlled. After decades of research, that remains a mystery.

One thing is certain: Avoiding excessive weight gain is crucial in preventing adult onset -- or type 2 -- diabetes, which affects about 17 million Americans. Research is focusing on how exercise prevents obesity and thus, diabetes.

"Once we figure that out, it might be very possible to design drugs and medications that act physiologically like exercise," says Shuldiner.

Until virtual exercise packed into a pill is available, good old-fashioned exercise is still the best bet for preventing adult onset diabetes.