risk

Trial gets underway aimed at preventing type 1 diabetes in at risk youngsters

by Barbara Hewitt on April 21, 2016

A clinical study evaluating a new hypothesis that an inexpensive drug with a simple treatment regime can prevent type 1 diabetes has been launched in the UK.

The autoimmune diabetes Accelerator Prevention Trial (adAPT) will look at giving metformin, the most common diabetes drug, to young people at high risk of developing type 1 diabetes to see if it can prevent the condition.

The study, led by Professor Terence Wilkin, of the University of Exeter Medical School, with support from colleagues at the University of Dundee and NHS Tayside aims to contact all 6,400 families in Scotland affected by the condition, with a view to expanding into England at a later date.

girls

Children aged 5 to 16 who have a sibling or parent with type 1 diabetes will be invited for a blood test to establish whether they are at high risk of developing the disease. If so, they will be invited to take part in the trial.

Researchers will then examine the impact of administering metformin to young people in the high risk category as a way of preventing diabetes and also explore why the incidence of type 1 diabetes has risen fivefold in the last 40 years.

Researchers have previously hypothesised that type 1 diabetes is an autoimmune disease caused by a faulty immune system which attacks and destroys insulin producing beta cells in the pancreas. Clinical trials have tried drugs that supress the immune system to attempt to subdue the attack, but the results have so far been disappointing.

The Accelerator Prevention Trial is the first to test an alternative explanation for type 1 diabetes, and is based on the accelerator hypothesis, proposed in 2001 by Professor Wilkin that autoimmunity occurs as a response to damaged beta cells.

He believes that beta cells, stressed by being made to work too hard in a modern environment, send out signals that switch on the immune system. The adAPT study will test whether metformin, which is known to protect the beta cells from stress, can stop the immune response that goes on to destroy them.

“We still have no means of preventing type 1 diabetes, which, at all ages, results from insufficient insulin. We all lose beta cells over the course of our lives, but most of us have enough for normal function,” said Wilkin.

“However, if the rate of beta cell loss is accelerated, type 1 diabetes develops, and the faster the loss, the younger the onset of the condition. The accelerator hypothesis talks of fast and slow type 1 diabetes, beta cell loss which progresses at different rates in different people, and appears at different ages as a result,” he explained.

It is thought that 80,000 children develop type 1 diabetes worldwide each year. There is currently no way of preventing childhood diabetes in children and no cure, meaning type 1 diabetes patients face strict dietary controls and multiple daily injections of insulin for life.

In the trial, each child will receive metformin or a placebo initially for four months, during which they will be tested three times to assess how their metabolism and immune system respond. The first stage of the trial will assess safety and whether the trial design works, whether the medication can reduce beta cell stress, and how many participants will be needed to progress the study. If the trial medication is found to lower beta cell stress effectively, the children in stage 1 will progress into the next stages of the trial.

“It is possible that a modern environment accelerates the loss of beta cells by overworking and stressing them. As a consequence, this could be contributing to the rising incidence of type 1 diabetes, which is appearing in ever younger age groups. The adAPT trial will use a medication to protect the beta cells from the stress, so that they survive longer. 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,” Wilkin explained.

According to Professor Stephen Greene of the University of Dundee and the Tayside Clinical Trials Unit, it is an exciting project. “A simple, safe and effective drug that would prevent the development of type 1 diabetes in young people would be a major breakthrough,” he said.

{ 0 comments }

Thumbnail image for Study confirms increased risk of bladder cancer with diabetes drug

Study confirms increased risk of bladder cancer with diabetes drug

April 19, 2016 News

Medical professionals should be aware that a common diabetes drug has been found to increase the risk of bladder cancer, scientists in Canada have warned. The association between the drug pioglitazone and bladder cancer risk should be taken into account when assessing treatment so that all risks and benefits are discussed, said the team of […]

Read the full article →
Thumbnail image for Relationship between diabetes and cancer is complex, new research has found

Relationship between diabetes and cancer is complex, new research has found

March 7, 2016 News

It is already known that diabetes is linked to an increased risk of some cancers but now new research shows that while the risk is there it is a much more complex relationship. A new study that analysed data from national registries of people with type 1 diabetes in Australia, Denmark, Finland, Scotland and Sweden […]

Read the full article →
Thumbnail image for New screening algorithm identifies new risk factors for type 2 diabetes

New screening algorithm identifies new risk factors for type 2 diabetes

February 19, 2016 News

Previously unknown risk factors for type 2 diabetes have been identified by research in the United States due to a new screening algorithm. A study conducted by researchers at the University of California’s Semel Institute for Neuroscience and Human Behaviour in Los Angeles says that the algorithm provides a cheaper and more accurate way to […]

Read the full article →
Thumbnail image for Sugary drinks associated with type 2 diabetes, say researchers

Sugary drinks associated with type 2 diabetes, say researchers

July 22, 2015 Diets

Drinking sugar sweetened drinks regularly has little benefit and has a direct link with the risk of developing type 2 diabetes, according to a new study by an international team of researchers. Indeed, they estimate that regular consumption could result in nearly two million new diabetes cases over 10 years in the United States and […]

Read the full article →
Thumbnail image for Specialist visit reduces heart disease risk in recently diagnosed type 2 diabetics

Specialist visit reduces heart disease risk in recently diagnosed type 2 diabetics

June 30, 2015 Diabetes General

People recently diagnosed with type 2 diabetes who have other serious chronic health issues have less heart disease and lower death rates if they see a specialist within a year, new research has found. Indeed, those who fall into this group who were seen by an endocrinologist had a 10% to 20% lower rate of […]

Read the full article →
Thumbnail image for Fast heart rate increases risk of type 2 diabetes, research confirms

Fast heart rate increases risk of type 2 diabetes, research confirms

May 26, 2015 Diabetes Research Polls

A faster resting heart rate can be linked to an increased risk of developing type 2 diabetes, according to a new four year study of more than 73,000 adults. People whose heart beats quicker than the usual 60 to 100 times a minute while at rest are 59% more likely to develop diabetes, researchers found […]

Read the full article →
Thumbnail image for Moderate coffee consumption may reduce type 2 diabetes risk by 25%

Moderate coffee consumption may reduce type 2 diabetes risk by 25%

November 19, 2014 Diabetes Research Polls

Regular, moderate consumption of coffee may decrease an individual’s risk of developing type 2 diabetes by up to a quarter, according to a new report. Epidemiological evidence shows that drinking three to four cups of coffee per day is associated with an approximate 25% lower risk of developing type 2 diabetes, compared to consuming none […]

Read the full article →
Thumbnail image for New test finds even diabetics who appear healthy may have heart damage

New test finds even diabetics who appear healthy may have heart damage

September 17, 2014 Diabetes Research Polls

People with diabetes who appear otherwise healthy may have a sixfold higher risk of developing heart failure regardless of their cholesterol levels, new research suggests. Researchers from the Johns Hopkins Bloomberg School of Public Health in the United States used an ultra-sensitive test to identify minute levels of a protein released into the blood when […]

Read the full article →
Thumbnail image for Researchers find nine genetic variants that increase risk of type 2 diabetes sevenfold

Researchers find nine genetic variants that increase risk of type 2 diabetes sevenfold

September 16, 2014 Diabetes Research Polls

Researchers in the United States have identified nine genetic variants that dramatically increase the risk of developing type 2 diabetes. The work carried out at Harvard Medical School is being hailed as significant as it adds to the existing knowledge of the disease’s underpinnings and provides a glimpse of its vast genetic diversity. The variants […]

Read the full article →
Thumbnail image for Gene found that increases risk of type 2 diabetes tenfold

Gene found that increases risk of type 2 diabetes tenfold

September 11, 2014 Diabetes Research Polls

Researchers have found a gene variant that increases by tenfold the risk of developing type 2 diabetes, which provides unique knowledge about the pathophysiological mechanism that leads to the disease. They have mapped a special gene variant among people in Greenland that suggests genetic explanations of diabetes are best achieved in small populations. It is […]

Read the full article →