Eureka 2019: New Hope for Individuals at High Risk for Developing Type 1 Diabetes

For the fifth year in a row, Endocrine News spoke with editors from Endocrine Society journals to get the scoop on the top endocrine discoveries of 2019. Here is part 4 of Eureka! 2019.

Endocrine Reviews Editor-in-Chief Daniel J. Drucker, MD, and senior scientist at the Lunenfeld Tanenbaum Research Institute of the Mt. Sinai Hospital in Toronto, Ontario, points to a paper that provides hope for individuals at very high risk for development of type 1 diabetes (T1D).

“This has been an elusive ‘holy grail’ type of result and should re-energize the science underlying the prevention of type 1 diabetes and efforts to preserve beta cell function in the face of an immune attack.”

Published in August in the New England Journal of Medicine, “An Anti-CD3 Antibody, Teplizumab, in Relatives at Risk for Type 1 Diabetes” by Herold, K.C., et. al. demonstrates that manipulating the immune system in these individuals can preserve beta cell function and meaningfully delay diabetes onset. The trial comprised 76 participants in two randomized groups, 44 taking teplizumab for a 14-day period and 32 taking placebo. Oral glucose-tolerance tests were then performed at six-month intervals to monitor progression to T1D. In those taking teplizumab, 14.9% per year were diagnosed with diabetes, compared to 35.9% per year in the placebo group.

“Teplizumab, a drug that partially blocks a component of the immune response that destroys insulin-producing islet beta cells, delayed progression to clinical type 1 diabetes in high-risk participants,” Drucker says. “This has been an elusive ‘holy grail’ type of result and should re-energize the science underlying the prevention of type 1 diabetes and efforts to preserve beta cell function in the face of an immune attack.”