MDNews - Greater Kansas

October/November 2020

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New Developments in Type 1 Diabetes Prevention BY K ATE ANASTAS T YPE 1 DIABE TES HA S BEEN KNOWN A S AN IRRE VERSIBLE CONDITION THAT NO ONE CAN FULLY PRE VENT. BUT NOW, SE VER AL BRE AK THROUGH STUDIES HAVE EMERGED THAT SHOW PRE VENTION AND MANAGEMENT FOR THE ILLNESS ARE POSSIBLE. AN E STIMATED 34 million adults in the U.S. have diabetes, according to the CDC's National Diabetes Statistics Report 2020. Type 1 diabetes accounts for about 5% of all diagnosed cases, or 1.6 million people. In recent years, research efforts have been focused on preventing and finding a cure for a condition that affects so many individuals. TEPLIZUMAB: PROVEN DELAY IN DIAGNOSIS Clinical studies have before researched the benefits of teplizumab, an anti-CD3 monoclonal antibody, to prolong insulin production for those diagnosed with Type 1 diabetes. But a recent study published in The New England Journal of Medicine was the first to not only predict patient development of diabetes but also show delay in onset of diagnosis. The phase 2 study was conducted by TrialNet and funded by the U.S. National Institute of Diabetes and Digestive and Kidney Diseases. It consisted of a randomized, placebo-controlled, double-blind trial study of 76 people between the ages of 8 and 49, each at high risk for developing Type 1 diabetes. Each participant was given teplizumab or placebo for two weeks and was monitored with oral glucose-tolerance tests at three months, six-month and then at six-month intervals. The study found that the drug could delay a Type 1 diabetes diagnosis an average of two years in high-risk adults and children. In even more updated data, the median delay of diagnosis has increased to three years. As far as development of diabetes, 72% of participants in the control group developed Type 1 diabetes, while only 43% in the teplizumab group had the illness—which showed the drug's potential to prevent the disease. Teplizumab was granted breakthrough therapy designation by the FDA in 2019. GOLIMUMAB: PRESERVED BETA-CELL FUNCTION A pediatric endocrinologist at the University at Buffalo led a phase 2 study of a drug already on the market, golimumab, to discover if it preserved beta-cell function in patients with Type 1 diabetes. The study was financed by the World Without Disease Accelerator through Janssen Research & Development. The study found golimumab could preserve beta-cell function in children and young adults newly diagnosed with the illness, as well as reduced the amount of insulin injections patients needed to produce insulin on their own. Golimumab is currently used to treat rheumatoid arthritis, ulcerative colitis and other autoimmune conditions but has never been approved by the FDA for treating Type 1 diabetes. This groundbreaking study presented data from a double-blind, placebo-controlled trial of 84 participants recently diagnosed with Type 1 diabetes. Each participant was given a dose of golimumab or placebo for 52 weeks. In the end, patients treated with golimumab had higher C-peptide levels in comparison with the control group. The group that was given golimumab was able to achieve good blood sugar control with less insulin. n 1 8❱❱❱❱❱ C L I N I C A L D I S C U S S I O N

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