Researchers have developed a groundbreaking medication that could delay the onset of type 1 diabetes, marking a potential shift in how the disease is treated even before symptoms arise. This new medication, which could redefine the management of type 1 diabetes, is now under review by the European Medicines Agency (EMA) for approval.
A New Hope for Diabetes Prevention
The drug, marketed under the brand name Tzield and based on the active antibody teplizumab, has shown promising results in clinical trials. It is designed to intervene in the disease's progression from its second to third stage, potentially delaying the need for daily insulin injections for several years.
Type 1 Diabetes is Divided into Three Stages
Insulin is produced by beta cells in the pancreas. Everyone starts at birth with 100 percent beta cell function, meaning 100 percent of the body's ability to produce insulin.
Over time, the immune systems of type 1 diabetics begin to develop resistance against the body's own insulin production.
Stage 1: The immune system develops antibodies against beta cell components, leading to an immune reaction against one or more of the body's own insulin-producing beta cells. At this stage, blood sugar regulation is still normal. Beta cell function is affected but remains above 80%. Some reach this stage without developing type 1 diabetes.
Stage 2: Two or more antibodies against beta cell components are still present, but blood sugar regulation is disrupted due to further reduced beta cell function. The risk for type 1 diabetes is high. Neither stage 1 nor stage 2 exhibits symptoms.
Stage 3: Clinical diagnosis of type 1 diabetes, requiring insulin treatment. The boundary between stage 2 and 3 is when beta cell function is down to about 20%. At this point, the body produces so little insulin that it can no longer process the sugar in the blood, and the cells will not receive sufficient nutrition.
Type 1 diabetes, traditionally managed through insulin replacement therapy following the onset of symptoms, might see a paradigm shift with Tzield.
How Tzield Works
Tzield targets the critical stage where the immune system begins to aggressively attack beta cells but before the body’s ability to produce insulin is significantly compromised. By preventing these immune attacks, Tzield can maintain beta cell function longer than would naturally occur in individuals with type 1 diabetes.
Tanja Thybo, the research director of the Diabetes Association, explained to Illustreret Videnskab that "It has been proven that Tzield can delay the development of type 1 diabetes by about 2 years, and in some cases, up to 7 years."
Screening and Early Detection
Identifying individuals who can benefit from Tzield is still a challenge, as it requires detecting the disease at stage 2, before any overt symptoms are apparent. Researchers suggest targeted screening of children who have a family history of type 1 diabetes as a viable method to identify potential candidates for the treatment.
The EMA's review of Tzield for use in individuals over eight years old who are at stage 2 of type 1 diabetes is a crucial step toward its potential availability. If approved, this drug could alter the landscape of diabetes treatment by reducing the dependence on daily insulin injections.
As research continues and more data become available, Tzield could lead the way to a future where type 1 diabetes is not only manageable but also substantially delayed, changing the lives of millions who are at risk of developing this disease.
