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Delaying Onset of Type 1 Diabetes may be possible soon

Researchers in US and Europe have been looking into various possibility of finding a vaccine to prevent Type 1 Diabetes- but none have or rather HAD succeeded so far. Different drugs ranging from Vitamin B to BCG vaccine gave been tried but without any success. Recently Scientists have found that an experimental drug Teplizumab may delay the onset of Type 1 Diabetes by 2 years- these results were presented at the recently concluded ADA 2019 annual conference in San Francisco researchers and simultaneously published in the New England Journal of Medicine.

Type1 Diabetes is characterized by lifelong requirement of multiple daily injections of Insulin-as the patients suffering from this type of Diabetes do not produce any Insulin of their own. Approx 2-5% of all diabetics constitute Type 1 Diabetes- this means there would be anywhere between 13.5 – 33 Lakh Type one diabetics in our country.

In Type One Diabetes the T Cells of immune system are activated by Antibodies to the Insulin secreting Beta of Pancreas, which results in the destruction of the Beta Cells ( the Insulin factory of our Body) so NO Insulin is produced and the effected person has to rely on external supplementation of Insulin because we cannot survive without Insulin. This disease usually starts at very early age- even in small children, But may effect adults as well. Unfortunately Insulin cannot be taken orally- it quickly gets destroyed by the Liver- only injections are helpful, Hence any person Diagnosed with Type one Diabetes has to take injections of Insulin throughout their life.

Teplizumab is a monoclonal antibody to the CD3 cells of immune system. Which means that the drug catches hold of T-Cells bearing CD3 molecules on their surface and deactivates them. The fact that subduing of the CD3 cells may delay or prevent the onset of Type 1 Diabetes was discovered in France during research on mice by French immunologists Lucienne Chatenoud and Jean-François Bach at Hôpital Necker-Enfants Malades in Paris way back in 1994.

The research team was headed by Dr Kevan Herald of Yale University, the trial was conducted by the Trial Network, where in participants where were at the initial stages of Type 1 Diabetes as they had mild rise in Blood Sugars and showed positive Antibodies for the Beta Cells of Pancreas, which means that the process of destruction of Beta cells had just started or was going to start soon..

Selected participants got an infusion of Teplizumab daily for 2 weeks. The study involved 76 participants aged between 8-49 years deemed to be at high risk of the condition.

Forty-four randomly assigned participants took teplizumab and 32 took a placebo. A total of 43% of those taking teplizumab developed type 1 diabetes, compared with 72% who took a placebo.

In those that developed type 1 diabetes, the researchers looked at the length of time it took for the condition to develop. In those taking teplizumab, the median average for developing type 1 was 48.4 months, compared to a shorter time of 24.4 months for those taking placebo.

The drug's performance was even greater in the first year, with just 7% of people taking the drug developing the condition, compared to 44% from the placebo group.

The side effects are mild and transient- Mild skin rashes and the decrease in White Blood cells caused by this drug reverses by itself in few weeks and is harmless. There were no severe allergic reactions of Anaphylaxis with the administration of this drug.

These results are promising and definitely encouraging, but more studies need to be done with larger numbers of participants, to prove the safety of this drug. Another important issue is that of identifying the ideal candidates for this treatment- only 15% of Type 1 Diabetics may be identified as they may have a relative with Type 1 Diabetes – rest 85% may be difficult to screen- universal screening may be very costly and not feasible.

Technology and drug research is breaking barriers at a very fast pace. Let us hope one day it may not only be possible to administer oral insulin but treat Diabetes as well.

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