Combination therapy could kickstart insulin production in type 1 diabetics

Tue, 24 Jun 2014
People with type 1 diabetes could regain their ability to produce insulin through a novel form of treatment designed to reset their immune system.

The treatment - a combination of two different medications - has been developed and tested by scientists in the U.S. who describe the results of their first trial as "profound".

To begin with, problematic immune system cells that may be behind a patient's inability to produce insulin are flushed out and destroyed using a medication called Thymoglobulin, which was initially developed for use in organ transplants.

Next, a cancer-treating medication called Neulasta is used to stimulate the production of new and potentially beneficial immune cells.

"The treatment is almost like trying to hit the reset button on the immune system," explained lead researcher Dr. Michael Haller, a paediatric endocrinologist at the University of Florida. "We're trying to wipe out the bad cells and stimulate the good cells at the same time."

Presenting the results of the first study last week at the annual meeting of the American Diabetes Association in San Francisco, Dr. Haller revealed that 17 adult patients with type 1 diabetes at least partially regained their ability to produce their own insulin.

The patients received the combination therapy for two weeks and were then followed for a year. Another eight patients were given a placebo. By the end of the year, insulin production had improved in those treated with the cocktail, indicating the preservation and increase of insulin-making beta cells.

What makes Dr. Haller and colleagues "cautiously optimistic" is the fact that the research only involved patients who had been long diagnosed with the disease. Most other studies focus on patients newly diagnosed with type 1 diabetes who still have some pancreatic beta cells intact and are therefore still able to produce small amounts of insulin.

The next phase of the research is to continue following the patients for 3-5 years to examine whether the beta cells can be preserved in the long-term, and to also conduct a larger trial of the treatment involving newly diagnosed patients.

"If we can confirm the results in a larger effort, the study could potentially be paradigm-shifting for our field in that it documents we should really be looking at combination therapies in treating Type 1 diabetes," Haller added.

"This study is an important step forward in our efforts to make life easier for patients with Type 1 diabetes."
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