Is there a way to prevent type 1 diabetes?

According to two new studies, researchers have found huge progress in delaying the onset of type 1 diabetes and slowing the progression of the disease.

Although new methods and strategies have been used to help prevent and manage type 1 diabetes, there is still no cure for the disease. The two new methods preserve the function of pancreatic insulin-producing beta cells immediately after a patient is diagnosed and delay the onset of type 1 diabetes in patients at higher risk of developing disease. Although they are not cured, both methods help to significantly improve the quality of life of patients. Some benefits include better blood sugar control, a lower risk of developing hypoglycemia, and a lower overall risk of disease-related side effects.

The first study looked at the preservation of beta cell function through combination therapy in new patients. The study that was conducted for this trial was a randomized, double-blind study. The study was also controlled by placebo. Therefore, no one knew who received the drug and the placebo before the end of the experiment.

This study included 308 patients aged 18 to 45 years. The inclusion criteria in this trial were a diagnosis of type 1 diabetes within 20 weeks and residual beta cell function. The 308 patients were divided into four groups of 77 each; one group received placebo, one liraglutide group, another monoclonal anti-IL-21 plus liraglutide group, and the last group received monoclonal anti-IL-21 alone.

The decrease in C peptide concentration stimulated by the mixed meal tolerance test (MMTT) from baseline to week 54 was significantly lower with the combination treatment than with placebo or with anti-IL-21 or liraglutide alone. At week 54, all active treatments achieved a greater decrease in A1c than placebo. The results of this trial show that the combination therapy has the potential to save beta cell function in patients recently diagnosed with type 1 diabetes.

The aim of the second study was to see if the onset of type 1 diabetes can be delayed in an individual. This study included 76 patients aged 8 to 49 years. The inclusion criterion in this study was a positive result for at least two type 1 diabetes autoantibodies. The 76 patients were divided into a placebo group and a treatment group. The treatment group received a 14-day infusion of teplizumab. Half of the treatment group were diabetes free at a median follow-up to day 923. They also showed improvements in their beta cell function. In the placebo group, only 22% of patients were diabetes-free at median follow-up. The results of this study showed that a course of teplizumab delayed the need for insulin in patients at high risk of developing type 1 diabetes for about three years.

Practice the beads:

• Combination therapy with monoclonal anti-IL-21 and liraglutide has the potential to save beta cell function in patients newly diagnosed with type 1 diabetes.
• Although a regimen of anti-IL-21 monoclonal and liraglutide helps preserve beta cell function in diabetes, more research needs to be done to prove the safety and effectiveness of this treatment.
• A course of teplizumab can delay the need for insulin for up to 3 years in patients at high risk of developing type 1 diabetes.

Miriam E. Tucker, Diabetes prevention is getting closer to reality according to published studies. Medscape, March 17, 2021.

Matthias von Herrath, MD Stephen C Bain, MD. Interleukin-21 Antibodies and Liraglutide for Preservation of β Cell Function in Adults with New-Onset Type 1 Diabetes: A Randomized, Double-Blind, Placebo-Controlled Phase 2 Trial. The Lancet, March 01, 2021.

Emily K. Sims, Brian N. Bundy, Teplizumab improves and stabilizes beta cell function in high risk antibody positive individuals. Science Translational Medicine, March 03, 2021.

Oluwatayo Ishola, PharmD. Candidate, South College, School of Pharmacy

Learn more about potential ways to prevent or delay type 1 diabetes.