Researchers May Have Found a Way to Reverse Type 1 Diabetes
Small clinical trials are showing early success.
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A diagnosis of type 1 diabetes means a lifetime of constant diligence. Unlike type 2 diabetes, type 1 usually develops early in life. Those diagnosed have to check blood sugar several times a day and take insulin as needed; the process is difficult, expensive, and potentially dangerous. That helps explain the excitement about a potential cure for type 1 diabetes using an already approved treatment.
Doctors diagnose more than 18,000 children and teens with type 1 diabetes every year, according to the CDC. These kids lack the ability to make enough insulin, the hormone that processes blood sugar. Using insulin injections to control blood sugar with insulin is tricky because diet, exercise, and stress can quickly alter levels. Without enough insulin, kidney, heart, and nerve damage can be the result. Get too much, and blood sugar levels will plummet dangerously low. (This is the difference between type 1 and type 2 diabetes.)
Researchers in Israel have tried treating type 1 diabetics with an immune system protein called alpha-1 antitrypsin (alpha-1)—it helps target germs. Normally, insulin gets lower and lower over time in diabetics, but extra alpha-1 seems to help the body produce more. Researchers gave 12 recently diagnosed type 1 diabetics an alpha-1 drip once a week for eight weeks in a study in The Journal of Clinical Endocrinology & Metabolism. For a year and counting following treatment, two of the participants have been making more of their own insulin. Another three saw only minor decreases—which is a good sign. “Compared to the natural course of the disease, which is downhill, even a flat line is considered success,” says study co-author Eli C. Lewis, PhD, biochemical and pharmacology professor at Ben-Gurion University of the Negev.
Another small study in the journal Pediatric Diabetes found that 18 alpha-1 treatments could decrease participants’ hemoglobin A1c, a measure of blood sugar over time and a target for insulin treatment. On average, their levels dropped from 8.43 percent to 7.09 percent. The target for hemoglobin A 1 c set by American Diabetes Association encourages is 7 percent or less.
The good news, says Dr. Lewis, is that alpha-1 infusions are already FDA-approved for treating a rare lung disease. Because the protein already occurs naturally in the body, it should be fine to use it for different conditions, he points out. “This is the safest approach today in any clinical trial.” In fact, research suggests it may be easier on the body than insulin injections. Some study volunteers had mild headaches, stomachaches, or coughs, but the side effects didn’t last long.
Diabetics often go through a “honeymoon” phase soon after diagnosis, when their symptoms get better but then go downhill again. But Dr. Lewis says his research isn’t just piggybacking off that natural improvement. “The oldest we’ve been following is almost ten years ago now,” he says. “This kid got eight infusions—eight weeks of infusions—and he’s still, ten years later, in the honeymoon.” The key is to start the treatment within 100 days of diagnosis, when the disease is still in its early phase, he says.
A few of Lewis’s study participants had been able to go off insulin altogether. One child had a blood sugar spike, but Dr. Lewis was actually happy. Turns out, the kid had eaten a slice of chocolate cake at a party. “This is what I wanted—kids to be active and eating cakes, not forced into a disease which is a box,” Dr. Lewis says. “He’s out of the woods. It’s two and a half years later, and he’s eating normally.”