Can an old drug prevent Type 1 diabetes?

An old drug to treat blood pressure might hold the power to preventing or delaying Type 1 diabetes in those at risk. Less than 10 percent of people with diabetes have Type 1 diabetes. Patients with Type 1 must take insulin to stay alive and there’s been no way to prevent the disease.

Now, for the first time, researchers say there may be a way to prevent or delay the disease in some people with a genetic risk.

Lisa Meyers wears an insulin pump and checks her blood sugar several times a day to keep her Type 1 diabetes in check.

“It’s a 24/7 thing,” Lisa said. “It’s just a constant thought about blood sugar and how it relates to what I’m going to do.”

She’s a diabetes educator and helps patients navigate the disease. It’s a job she wishes she didn’t have.

“If other people could be prevented from having to live this, that, to me, is a joy,” she said.

Dr. Aaron Michels said doctors are better than ever at predicting who will develop Type 1 diabetes.

“If a disease can be predicted, it really should be prevented,” Michels said.

About 60 percent of patients have a gene called HLADQ8. In a yearslong search for a way to block that gene, Michels found promise in an unlikely place, a decades-old blood pressure drug called methyldopa.

“It blocked DQ8,” Michels said. “It blocked its function.”

That means the drug could delay the diagnosis, or even prevent it altogether. If the research pans out in bigger trials, it will be a major milestone.

“Living with diabetes is a lot of work,” Michels said. “And it’s a lot of work that doesn’t go away.”

For Michels, it’s personal. He’s been living with Type 1 diabetes for 26 years.

“Things really do need to be done to lessen the burden for patients and their families,” he said.

His oldest daughter has it too.

“Any amount of time we can have a child and their family not have to deal with those burdens of Type 1 diabetes would be fantastic,” he said.

People with the DQ8 gene are about 10 times more likely to develop Type 1 diabetes.

A larger clinical trial will start enrolling patients in the next couple of months. People with a relative with Type 1 diabetes can get tested for the DQ8 gene. If they have it, they may be a candidate to enroll in the trial.

REPORT: MB #4522

BACKGROUND: Type 1 diabetes (previously called insulin-dependent or juvenile diabetes) is usually diagnosed in children, teens, and young adults, but it can develop at any age. If you have type 1 diabetes, your pancreas isn’t making insulin or is making very little. Insulin is a hormone that enables blood sugar to enter the cells in your body where it can be used for energy. Without insulin, blood sugar can’t get into cells and builds up in the bloodstream. High blood sugar is damaging to the body and causes many of the symptoms and complications of diabetes.

TREATMENT: It is possible to predict the development of type 1 diabetes. By measuring the presence of autoantibodies in the blood, it is possible to detect whether the immune system has begun to break down the body’s own insulin cells. Antibodies are part of the body’s immune system and the presence of antibodies in the blood is a sign that the immune system has reacted to an intruder such as a virus or a bacteria. Sometimes, the immune system mutinies and attacks the body. Autoantibodies are a sign of an autoimmune disease and form markers indicating that an attack is underway, for example on the body’s own insulin cells.

NEW RESEARCH: Aaron Michels, MD, Associate Professor of Pediatrics & Medicine at Frieda and George S. Eisenbarth Clinical Immunology and Endowed Chair at the University of Colorado Anschutz Medical Campus and other researchers came to their findings by using a “supercomputer” to analyze every small molecule drug that had been approved by the FDA. The study revealed that, as well as inhibiting DQ8, methyldopa did not interfere with the immune functioning of cells. The latter point is one of the downfalls of immunosuppressant medications, which have also been investigated for the prevention and treatment of type 1 diabetes. The researchers confirmed their findings in mice, as well as in a clinical trial of 20 individuals with type 1 diabetes. According to the scientists, these findings may have “significant implications” for the prevention and treatment of type 1 diabetes. A larger clinical trial of methyldopa for the prevention and treatment of type 1 diabetes funded by the National Institutes of Health (NIH) is set to start this spring.

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