
In Belgium, more than 3,300 children live with type 1 diabetes. Type 2 diabetes is also becoming more common. VUB professor Willem Staels recently received the FID-ISPAD Diabetes Research Grant 2024 for his research into childhood diabetes. âWe need to shift from managing the disease to curing it.â
Is diabetes becoming an epidemic among children as well?
Willem Staels: âThe number of children with type 1 diabetes in Europe has been rising for over 30 years. Type 1 is an autoimmune disease. Immune-related conditions in general seem to be on the rise. Weâre also seeing type 2 diabetes â once known as âadult-onsetâ â even in primary school children. In places like South America and among Indigenous communities in Canada, the disease is already reaching epidemic levels. Itâs still rarer here, but rising childhood obesity â a major risk factor for type 2 â suggests that trend wonât stop on its own.â
âThe addictive pull of fat, salt and sugar is not to be underestimatedâ
Where does current diabetes care fall short?
âChronic care is still the standard. Children with type 2 usually start on oral medication. For type 1, insulin is needed straight away. Thatâs a heavy burden. Diabetes is a 24/7 condition â every meal, every bit of exercise, every night. Thereâs no âholidayâ from the disease. Frederick Banting already said it a century ago: âInsulin is a treatment, not a cure.â We desperately need disease-modifying therapies that can slow or even reverse the condition.â
What new insights has your research uncovered?
âOur research focuses on the beta cell â the pancreas cell that produces insulin and is key to keeping blood sugar levels in check. In type 1 diabetes, the immune system attacks these cells. In type 2, theyâre worn out from years of overwork due to fats and sugars. Weâre exploring different avenues, including the transplantation of donor beta cells. Thatâs already being done in the clinic for a select group of patients with very unstable blood sugar levels â and with success. Some go years without needing insulin, and seem effectively cured. But the protection doesnât last forever, and there simply arenât enough donors to go round. Plus, itâs only available in specialised transplant centres like UZ Brussel.
Then thereâs the immune system. It rejects foreign cells, so patients need immunosuppressive drugs â which come with increased risks of infections, abnormal cell growth, even cancer. Thatâs why weâre now focusing on stem cell therapy. How can we turn lab-grown stem cells into strong beta cells that regulate sugar levels automatically? We recently discovered that iron plays a crucial role in beta cell function. Itâs not just a âbuilding blockâ â itâs more like âfuelâ. If thereâs a shortage or imbalance in iron metabolism, these cells become stressed and damaged more easily. By restoring or fine-tuning iron balance, we might not only help these cells survive longer but also make them work better. Our goal is to develop therapies that tackle diabetes at the root cause.â
When do you think this technique will be ready for use?
âThe potential is huge. It could cure both type 1 and type 2 diabetes â though weight loss will always be key in type 2. But there are still hurdles. How can we stop the immune system from rejecting new beta cells without resorting to heavy-duty medication? Breakthroughs have been announced for 20 years now, often with great fanfare. I donât want to commit to a hard deadline, but weâre closer than ever. Research is speeding up, and weâre already producing insulin-making beta cells good enough for clinical trials. The processes are improving all the time.â

Willem Staels
How important is prevention in type 2 diabetes?
âBetter prevention and treatment are absolutely essential. The new multidisciplinary care centres in Belgium are a step in the right direction, but the most vulnerable people still often miss out. Healthy food is more expensive, and people donât always have the right information. The food industry makes ultra-processed junk dirt cheap and constantly available. The addictive effect of fat, salt and sugar is no joke. Weâre hardwired to crave them â our bodies store them for âharder timesâ. But once fat mass gets too high, itâs incredibly hard to lose. Your body clings to a certain âset pointâ. Genetics also plays a role: some people are naturally more efficient at storing fat and holding onto it. Obesity is complex and multifactorial. As Maggie De Block rightly said: many people with obesity have already tried countless diets. We need to drop the stigma and treat obesity as a disease. Only then can we really tackle it.â
What are the main health risks?
âWith obesity, itâs not about the kilos themselves, but where the fat ends up. Subcutaneous fat is relatively harmless. But once that âstorage spaceâ fills up, fat starts to settle deeper â in the liver, around the heart, kidneys, pancreas⊠That impairs how those organs work. Weâre already seeing fatty liver and high blood pressure in children. Obesity in early life is the biggest predictor of obesity in adulthood. And itâs hard to shake off, with serious consequences: reduced organ function, insulin resistance, (pre)diabetes, cardiovascular disease and even cancer. The longer your body is in that state, the bigger the impact on your quality of life and life expectancy.
With type 1 diabetes, the danger isnât just high blood sugar â itâs the dangerous swings. Low values can cause loss of consciousness or even seizures. High values arenât felt right away, but over time they cause âsugar damageâ in small blood vessels, leading to complications like blindness and diabetic foot. We donât see those in children yet, but if diabetes isnât well controlled, complications in adulthood can become a major issue.â
How important is early detection?
âHugely important. Diabetes often simmers for years. By the time symptoms show, up to 60% of beta cells may already be lost. Thatâs why weâre launching screening programmes to detect early changes. Hopefully we can influence the course of type 1 diabetes that way. The earlier it starts, the more aggressive it tends to be â and the faster the remaining beta cells disappear. You should always be alert to signs like excessive thirst, frequent urination, weight loss and fatigue. A simple finger prick or urine test is enough to rule out diabetes.â
âResearch helps us improve and opens up new perspectivesâ
Whatâs your view on the evolution of diabetes technology?
âTechnological progress is impressive. Insulin pumps and sensors increasingly automate insulin delivery, making life a bit easier. But tech isnât the whole story. A child with little support at home, or a teenager who just wants to be a teenager, might forget to refill the pump or replace the sensor. People arenât robots â alarms, faulty readings, skin irritation all bring new challenges. The ultimate goal is still to restore the natural function of the beta cell. That would ease the treatment burden for everyone â regardless of age or background â and give them more freedom.â
What motivates you as a doctor?
âAs a paediatric endocrinologist, I get to support children on their journey to adulthood. I want diabetes to be part of their lives, not the whole story. Itâs a balancing act: setting limits where needed, but with empathy and respect for their independence. The aim is for children to understand whatâs good for them, so they rely less on healthcare providers. That trust â with the child and their parents â is central to everything I do. Together, we look for the best approach.â
You combine clinical work with research. Why is that combination so important to you?
âThe reward in the clinic is immediate: every consultation makes a difference. With research, the payoff takes longer. You spend years on one topic, hit roadblocks, have to start again. That demands resilience and patience, but also fuels my curiosity. I want to understand things deeply and help move the field forward. Just doing clinical work would keep medicine as it is. Research lets us improve it and open up new possibilities. For me, itâs the perfect mix: challenging, meaningful, and incredibly rewarding. Honestly, Iâd do it even if I didnât get paid. The team spirit in the hospital and lab is a huge part of that â but above all, itâs just brilliant work.â*
*This is a machine translation. We apologise for any inaccuracies.