A new Scottish study will investigate if lifestyle and environmental factors affect the development of type 1 diabetes, and whether metformin could prevent the acceleration of beta cell destruction.
The research is a joint initiative between the Universities of Exeter and Dundee. Scientists will contact all 6,400 families in Scotland that are affected by type 1 diabetes and invite children aged five to 16 who have a sibling or parent with the condition to have a blood test. This will assess if they are at high risk of developing type 1 diabetes.
Those who have a high risk will be offered the chance to participate in the Accelerator Prevention Trial (adAPT) study, which will split participants into two groups: one will take the diabetes drug metformin for four months, and the second will take placebo.
Metformin is commonly used to treat type 2 diabetes because it reduces the stress put on insulin-producing beta cells. Researchers now want to investigate whether it could prevent diabetes from developing in the first place.
The well-known theory behind type 1 diabetes is that the immune system mistakenly attacks the insulin-producing cells in the pancreas. This new study will aim to challenge this long-established hypothesis.
The research will test the “accelerator hypothesis” theory of Professor Terence Wilki, from the University of Exeter Medical School, which suggests that lifestyle and environmental stresses could initially damage beta cells before type 1 diabetes develops. These damaged cells then transmit signals that trigger the immune system to attack them.
Wilkin said: “It is possible that a modern environment accelerates the loss of beta cells by overworking and stressing them. If successful, the trial will offer a means of preventing type 1 diabetes with a cost-effective medication, and could be made immediately available to children at risk.”
The study will be conducted in Scotland because it has the third highest incidence of type 1 diabetes in the world. The trial will then be gradually expanded to include health boards in England.

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