For years, it’s been possible to predict who is at highest risk for developing type 1 diabetes based on family history and genetic factors. But for most of this time, there hasn’t been a lot that doctors can do with this information — other than regularly screen people for diabetes and start treatment as soon as possible.
But now, for the first time, researchers have shown that an intervention can significantly delay the onset of type 1 diabetes in high-risk individuals.
On Sunday, June 9, at the American Diabetes Association’s 79th Scientific Sessions in San Francisco, researchers presented findings from the Teplizumab (Anti-CD3) Prevention Study, which gave an immunotherapy drug to both children and adults at high risk for developing type 1 diabetes.
All participants had relatives with type 1 diabetes, had two or more autoantibodies in their blood, and had abnormal blood sugar levels — but not yet at diabetic levels — at the beginning of the study. According to the researchers, these three factors put a person’s lifetime risk of a type 1 diabetes diagnosis at close to 100%.
Previous studies have shown that teplizumab can prolong insulin production in people recently diagnosed with type 1 diabetes, but this study was the first to test the drug’s effect in people at high risk for the condition.
Between July 2011 and November 2018, 76 participants — ages 8 to 49 — took either teplizumab or a placebo (inactive pill). During that period, 72% of people in the placebo group were diagnosed with diabetes, compared with only 43% of people in the drug group.
On average, 36% of people in the placebo group were diagnosed with diabetes each year, compared with 15% of people in the drug group. This corresponds to a median delay in diagnosis of about 2 years.
These results are significant because “particularly for children who are most commonly affected, every day you can delay this disease is important,” says the study’s chair, Kevan Herold, MD, a professor of immunobiology and internal medicine at Yale University.
“A delay in diagnosis is likely to have long-term benefits on glycemic control and the development of acute and long-term complications of type 1 diabetes,” explains Aaron J. Kowalski, PhD, president and CEO of JDRF, which helped fund the study. Ultimately, he says, “delaying the progression of the disease is an essential and impactful step toward the prevention, and ultimately a cure for type one.”