Type 2 diabetes affects hundreds of millions globally and remains one of the most pressing non-communicable disease challenges in India. Traditionally, clinical focus has centred on insulin resistance, lifestyle interventions and beta-cell dysfunction. However, a recent breakthrough study from IIT Bombay has revealed a little-noticed player in disease progression: the structural protein collagen I. According to the researchers, collagen I may act as a scaffold that accelerates the aggregation of the hormone amylin in pancreatic tissue, thereby contributing to beta-cell damage and advancing diabetes beyond what standard models account for.
The new findings, published in the Journal of the American Chemical Society (JACS), underscore the significance of the extracellular environment, specifically the extracellular matrix, rather than solely internal cellular mechanisms in type 2 diabetes progression. For patients and clinicians in India, where the diabetes burden is enormous, this insight adds a layer of urgency. Could therapies that ignore the role of collagen be missing a vital target?
Why The Collagen-Diabetes Link Matters
Diabetes is often framed in terms of insulin resistance, impaired insulin secretion or beta-cell loss. Yet mounting research emphasises the role of the extracellular matrix (ECM) in insulin action. A 2016 review found that in muscle, liver and adipose tissue increased ECM deposition (including collagen) predicts insulin resistance.
The IIT Bombay study extends this by focusing on the pancreatic islet environment itself: fibrillar collagen I appears to accelerate the clumping of amylin (secreted alongside insulin from beta-cells) which then becomes toxic, damages beta-cells and undermines insulin production. The human and mouse data from the study showed that as diabetes progressed, levels of collagen I and amylin both rose in tandem in islet tissue. In lab experiments, beta-cells grown on collagen scaffolds and exposed to amylin displayed increased cell stress, higher death rates and lower insulin secretion compared to those grown without the collagen substrate.
Implications For Patients With Type 2 Diabetes In India
India currently has an enormous burden of type 2 diabetes, estimated over 100 million adults and rising. The new study suggests that beyond glucose-lowering medications, lifestyle and diet, we may need to consider extracellular matrix therapies or interventions that modify the islet-microenvironment. For example, patients with longstanding diabetes or those showing poor response to treatment might have advanced ECM/collagen changes making the disease harder to reverse.
Moreover, the findings could influence how we view popular collagen supplements. While these are marketed for joint, skin or bone health, their impact on the pancreas in diabetes is unconstrained and may warrant caution, though the study itself did not test oral supplements directly.
Cautions And What The Study Does Not Yet Show
Despite the breakthrough, the study remains pre-clinical in many respects. It does not establish that collagen supplements worsen diabetes in humans, nor does it provide direct clinical trial evidence that targeting collagen I will reverse diabetes. Additionally, while the ECM-collagen mechanism is compelling, it is but one of multiple pathways in type 2 diabetes (including lifestyle, genetics, epigenetics, immune changes). As the authors emphasise, more work is needed to move from mechanistic insight to therapy.
Should Diabetes Patients Avoid Collagen Then?
- Clinicians treating type 2 diabetes should be aware of emerging biology, not as a reason to change standard of care, but as context for patients who are not responding as expected.
- Patients should continue evidence-based lifestyle habits like diet, exercise, weight management, blood-glucose monitoring, since these remain the foundational interventions.
- Before using collagen supplements especially in the context of diabetes, a conversation with an endocrinologist is advisable; the long-term implications in diabetes are as yet unstudied.
The IIT Bombay study marks a significant shift in how we view type 2 diabetes, not just as a metabolic disorder of insulin and glucose, but as a disease embedded in a complex tissue environment where structural proteins like collagen I may play an active role in disease progression. For India, where diabetes is widespread and many patients struggle with sub-optimal responses, recognising these hidden mechanisms can open new horizons.
That said, we are not there yet in terms of new treatments: the mainstream remains lifestyle control and appropriate medication. But this research signals that future therapies may move beyond cells-and-hormones to include the very "scaffolding" around those cells.
Disclaimer: This content including advice provides generic information only. It is in no way a substitute for a qualified medical opinion. Always consult a specialist or your doctor for more information. NDTV does not claim responsibility for this information.
