“A paradigm shift is coming for type 1 diabetes. This is what he announced Colin Dayanfrom the Diabetes and Autoimmunity Group of the Faculty of Medicine, Cardiff University (UK), at a conference he led at the XXXV National Congress of the Spanish Diabetes Society (SED), which took place in Granada.
Type 1 diabetes, which is estimated to affect around 90,000 people in Spain, is a chronic disease caused by the pancreas does not synthesize enough insulin, the main function of which is to maintain adequate levels of sugar (glucose) in the blood. Within this pathology, there are two main types: idiopathic in nature and autoimmune in origin. In the latter case, insulin factories (pancreatic beta cells) are destroyed by autoantibodies; That is, the body attacks its own cells as if they were foreign.
Today, people with this condition continue to rely on injections or continuous insulin pumps to replace the hormone their bodies are unable to produce. However, according to the expert, “Insulin does not provide satisfactory glycemic control in most people and there remains a significant unmet need for new treatments for type 1 diabetes.”
This situation is on track to improve thanks to the development of alternatives to insulin, especially what is known as low risk immunotherapy, which aims to preserve beta cell function so that exogenous administration of the hormone is not necessary. Thus, insulin and beta cell replacement using stem cells or transplantation will be seen as “rescue therapy reserved for late cases” in the future.
In particular, Dayan expressed enthusiasm for the “recent approval the drug teplizumab, which allows you to delay the need for insulin for 2-3 years.” This is the first representative of a new era of immunotherapy for type 1 diabetes. In fact, according to the specialist, “there are at least seven other drugs that also have beneficial effects and should be able to extend this period even further.” In his opinion, “there is no doubt that it is now possible to delay the loss of insulin-producing cells with low risk for patients and, in addition, we can now extend this period of “type 1 diabetes without insulin” for a longer period. ”
They were published in the magazine in October 2023. New England Journal of Medicine positive results from phase 3 clinical trials of this drug.
Teplizumab is already approved in the US but is not yet available in Spain because it does not have approval from the European Medicines Agency (EMA). Near a monoclonal antibody designed to prevent the progression of type 1 diabetes. which acts specifically on T cells, which form an important part of the body’s defense system (immune system).
The use of teplizumab in the US is currently limited those people who are at high risk of developing type 1 diabetes, but have not yet reached the stage where the disease manifests clinically to delay disease progression. These are relatives of people with type 1 diabetes who have abnormal glucose levels without symptoms and two or more pancreatic islet autoantibodies.
The most common side effects of teplizumab include hypoglycemia, headache, nausea, rash, lymphopenia, and vomiting. Less commonly, this drug may have more serious side effects, such as cytokine release syndrome (a set of symptoms that can develop as a side effect of certain types of immunotherapy, particularly those involving T cells) or infections.
Therefore, the task is to fight this pathology at the root, that is, through prevention. “We need to think about how to test first-degree relatives of people with type 1 diabetes (in whom the risk increases 10-fold) and then the general population for preclinical type 1 diabetes (using islet autoantibodies). before too many insulin-producing cells are lost– advises the British expert.
It is now possible to control the disease for many years without the need for insulin, although ongoing treatment may be required. The next task, according to the speaker, is to be able to postpone indefinitely the dependence on injections or pumps: “If we understand the stages of the disease, we can move to non-insulin type 1 diabetes“
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