Diabetes Trials

Current trials in Type 1 Diabetes Mellitus

As with many other diseases, there is much interest in monoclonal antibodies as a novel treatment for diabetes. In particular, the drug otelixizumab is being tried in people who have recently been diagnosed with Type 1 Diabetes. The drug has to be given by intravenous infusion, but it may have benefits for many months, or even years, after treatment.

Another major advance in medical treatment in the past few years is the potential use of cell-based technologies. A study is currently recruiting patients to find out if transplantation of islet cells can help to treat severe diabetes. Islet cells are the insulin-producing cells in the body, and they are lost or damaged in Type 1 diabetes.

An interesting new treatment, which involves infusing an enzyme called GAD (glutamic acid decarboxylase), aims to preserve the body’s own insulin-producing ability in people who have just been diagnosed with diabetes. Even if it is not possible to reverse the damage already done to the body’s ability to make its own insulin, GAD could be used to prevent further damage. This would mean better control of glucose levels, and fewer complications like heart attacks, strokes and eye and kidney damage.

There is a great deal of interest in new treatments that don’t require needles. Long-term use of inhaled insulin may potentially cause damage to the lungs, so one group of scientists are investigating a type of insulin that is absorbed across the lining of the mouth. The drug is a possible replacement for the “before mealtime” injections that many diabetics hate. It is administered as a fine mist from a spray.

Trials in relatives of diabetics

A study is currently underway to discover whether it is possible to prevent diabetes from developing by giving oral insulin to relatives of diabetics. Sadly the oral insulin is not effective in lowering blood glucose, so it won’t be hitting the shelves as a treatment for diabetes. The idea behind giving oral insulin to people at risk of diabetes is that this might prevent them from forming antibodies to insulin. By preventing this immune response, the researchers hope to prevent the development of diabetes, in much the same way as giving cockroach juice to asthmatics is thought to prevent cockroach allergies.

Future directions

Stem cell technology is an exciting advance in medical research that has enormous potential to treat diseases such as diabetes. Only ten years after this field of research was created, a therapeutic trial is due to start soon of stem cells in diabetics. Another similar trial will use blood taken from the umbilical cord of newborn babies to treat diabetics. This “cord blood” is rich in stem cells, and it is normally thrown away after the cord is cut.

Another line of research aims to find out if immune-system controlling drugs, like the drugs used to prevent rejection of organ transplants, can prevent the immune system from causing the damage that ultimately leads to diabetes. One such drug, sirolimus, is already widely used in transplant patients, and a new trial will test it in diabetes.