The Cure:Are We There Yet?

Melinda Seed writes for Twice Diabetes

Spoiler alert: The answer is a resounding NO!

As you’d know from my frenzied tweeting last week and my last blog post about tech I was at the Australasian Diabetes Congress #19ADC last week. Rather than do a highlights post, I’ve decided to do some topic specific posts on what I learned at the Congress. Coming soon is research about effectiveness of technology in type 1, what’s new in food and diabetes and where’s the voice of the people with D?

Although there are no game-changers yet in terms of the cure I was encouraged to hear about some more small steps in piecing together the puzzle of type 1 diabetes.

Delaying the Onset of Type 1

These results were announced earlier this year I think but are worth reiterating:
*A single two-week treatment with teplizumab delayed the onset of T1D in non-diabetic relatives who were at very high risk for development of clinical T1D.
*The delay in the median time to diabetes was 2 years.
*43% of teplizumab treated subjects developed T1D as compared with 72% of those receiving placebo.
*Teplizumab can be safely administered in children and adults who are at risk for t1D
*Subgroups of individuals identified by characteristics at screening, may have particularly robust responses to teplizumab.
This is the first trial to show that immune therepy can be used to delay T1D.

The next step is discovering the biomarkers that will identify those people most likely to respond, seeing if repeated dosing is efficacious whether teplizumab can be combined with other agents with complimentary mechanisms of action to increase the efficacy towards delaying or preventing. If you are interested in getting involved in screening visit https://type1screen.org

Islet Cell Transplants

Islet cell transplants are accepted as a viable treatment for severe hypo unawareness. A lack of islet cells available for transplant plus the need for immunosuppression means this isnt ever going to be a treatment for more than a handful of people with severe hypo unawareness a year.

One of the big problems that hinders greater success in the population of people eligible for islet cell transplants is the immune response that takes place in the liver in the first few days after transplantation, apparantly a lot of the islet cells die. I first blogged about an Aussie approach to fixing this when it was touted in 2016 and it is encouraging to see that what was reported there, really is going to turn into a human trial. Synthetic skin, developed for treating burns victims is a potentially great means of transplanting islet cells, “The transplantation site is intra-cutanous in a neo dermis, and NOT subcutaneous”. The model has been used in large animals (piggies) and human clinical trials will begin in early 2020. This has the potential to improve the success of islet cell transplants in curing severe hypoglyceamia. Great to see another example of ground breaking research coming from Australia, this time, the University of Adelaide.

The Problem with Curing Mice

All those jokes about there’s a lot that can be done if you’re a mouse with diabetes, are sort of true. I found one of the presentations that highlighted some of the difficulties with the mouse model of diabetes useful, in short, mouse models are unlikely to translate to people, at least without an enormous number of intermediary steps: (sorry for poor quality image).


Disclaimer, Diabetes Australia organised a media pass for me to attend the Congress as part of their “DA Peoples Voice” initiative. All views expressed are mine and do not in anyway represent Diabetes Australia. Thank-you to DA and the ADS-ADEA for their support of this initiative.

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