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MONDAY, June 10, 2019 (HealthDay News) – A two-year delay in the onset of type 1 diabetes could make a big difference for people with the disease. And researchers say that a new drug can make this postponement possible.
The researchers gave the drug, teplizumab or placebo, to a small group of people who were almost certain to develop type 1 diabetes, based on genetics and certain symptoms. Those who received a placebo, or dummy drug, have progressed to type 1 diabetes in just over 24 months on average. People who received the drug developed autoimmune disease in 48 months on average.
According to Jessica Dunne, senior director of research at JDRF (formerly the Juvenile Diabetes Research Foundation), it will take at least a few years before this drug can be approved for use outside of a trial. clinical.
Nevertheless, "preventing children from having insulin for as long as possible is really exciting," Dunne said. "This study shows that with a short treatment it is possible to give people two years less insulin shots, finger pricks and daily monitoring."
Dunne also noted that a delay means that a child could be more mature and able to manage the disease. "The difference between a diagnosis of 12 years and 14 years is huge," she said.
A delay in diagnosis also means two years less with the disease. This could result in fewer complications later in life, according to JDRF.
"This is the first study to show that any drug can delay the diagnosis of type 1 diabetes by a median of two years in high-risk individuals," said Dr. Kevan Herold, lead author of the study, in a press release issued by the school.
Type 1 diabetes occurs when the body's immune system mistakenly attacks insulin-producing cells called beta cells in the pancreas. Insulin is a hormone that helps the body's cells to turn the sugar in food into fuel.
These people need to replace this lost insulin with daily injections or an insulin pump. According to the study's authors, nearly 1.5 million Americans have type 1 diabetes.
Teplizumab targets specific types of cells in the immune system, interfering with the destruction of beta cells.
The study included 76 people aged 8 years. Most were under 18 years old. They were at high risk of developing type 1 diabetes. They had a parent with type 1 diabetes and evidence that their own immune system may have already been attacked by beta cells (autoantibodies). The study volunteers also showed signs that their body was not treating blood sugar normally.
Just over half of this group received teplizumab for two weeks intravenously. The others received a placebo by IV. Participants in the study were followed until they developed type 1 diabetes. The average follow-up study for most was three years, although some of the Participants in the study have not yet developed diabetes and are still being followed.
In addition to delaying the average onset of type 1 diabetes by two years, researchers found that only 43% of patients in the treatment group developed type 1 diabetes compared to 72% in the placebo group.
The results were presented Sunday at the meeting of the American Diabetes Association in San Francisco. They were published simultaneously in the New England Journal of Medicine.
Dr. Clifford Rosen of the Maine Medical Research Institute and Dr. Julie Ingelfinger of Mbadachusetts General Hospital wrote an editorial in the same issue of the journal.
"The results of this essay are striking, with several reservations," they wrote.
One important caveat, they said, is that these results should not be interpreted as a cure. But the findings provide clues about the potential causes of type 1 diabetes and suggest ways to possibly try to alter the course of the disease.
Editorialists also noted that the study was small and involved only a two-week treatment.
Dunne, of JDRF, agreed that the study raises new questions to explore, for example, what would happen if people were receiving more treatment? Or if this medicine was used with another?
But she said: "This study is particularly compelling because it was only a single treatment."
Funding for this study was provided by the US National Institutes of Health, JDRF and the American Diabetes Association.
More information
JDRF offers more facts and details about type 1 diabetes.
SOURCES: Jessica Dunne, Ph.D., Senior Director of Research, JDRF; June 9, 2019, New England Journal of Medicineand presentation, meeting of the American Diabetes Association, San Francisco
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