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HealthFirst-Arthritis drug for diabetics

Friday, August 28, 2009

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Leslie Toldo
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UNDATED -- (08/28/09) -- An arthritis drug may hold the key to stopping type-one diabetes.

HealthFirst reporter Leslie Toldo has more information on the experimental treatment that may help people in the early stages of diabetes.

A jam session in the garage is just what the doctor ordered for diabetic Daniel Albright. "It's just a way to get energy out, for sure."

The 17-year-old has type-one diabetes, one of three kids in the Albright family with it.

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Since his siblings were diagnosed first, Daniel was monitored, and doctors spotted signs of his diabetes early. Right now he's in a honeymoon period. His body's still producing some insulin.

"Instead of saying, 'Oh well, you have diabetes, here's the medication and here's the teaching,' let's see what we can do to prevent it from getting worse -- to stop it in its tracks," said Daniel's mother, Donna.

Daniel enrolled in a clinical trail to put the brakes on his diabetes. He gets monthly infusions of a rheumatoid arthritis drug called abatacept. The goal is to stop Daniel's immune system from killing the insulin-producing cells he has left.

"When you're first diagnosed with diabetes, you probably have anywhere from 10 to 30 percent of your insulin-producing cells still available, and we'd like to freeze it there," Dr. William Russell said.

In animal testing, the drug prevented full-blown diabetes from developing. In people, that would mean lower doses of insulin, easier blood sugar control and a lower risk of hypoglycemia, or dangerously-low blood sugar.

"It's much easier to take care of diabetes when the patient themselves is making adequate amounts of insulin," Russell explained.

After a couple of months of infusions, Daniel uses less insulin than his siblings, and he doesn't need a pump.

The drug Daniel is taking is FDA approved for rheumatoid arthritis, but has yet to be approved for diabetes.

A weakened immune system is one of the drug's side effects.

PUTTING THE BRAKES ON DIABETES

BACKGROUND: Type 1 diabetes, once known as juvenile diabetes or insulin-dependent diabetes, is a chronic condition where the pancreas produces little or no insulin. Insulin is a hormone needed to allow sugar to enter the body's cells to produce energy. It is much less common than type 2 diabetes, which occurs when the body becomes resistant to the effects of insulin or doesn't make enough insulin. Having type 1 diabetes increases the risk for many serious complications including heart disease, blindness, nerve damage and kidney damage. Although type 1 diabetes typically appears during adolescence, it can develop at any age. Various factors contribute to the disease including genetics.

Good glucose control for diabetics means getting as close to a normal blood sugar level as you safely can. Ideally, this means levels between 70 and 130 mg/dl before meals, and less than 180 two hours after starting a meal, with a glycated hemoglobin level of less than 7 percent, according to the American Diabetes Association. Every bit you lower your blood glucose level helps to prevent complications.

NEW STUDY: The Vanderbilt Eskind Pediatric Diabetes Clinic is taking part in a national type 1 Diabetes TrialNet study testing an arthritis drug called abatacept. The hope is that the drug can stop a rogue immune system from killing the body's insulin-producing cells. Participants must be within the first 100 days of diagnosis of type 1 diabetes. "The goal is to slow down or stop the inflammation at that stage because we know that there's still a good percentage of the insulin-producing cells still functioning," William Russell, M.D., Director of Pediatric Endocrinology & Diabetes at Vanderbilt University Medical Center in Nashville, Tenn., told Ivanhoe. "If we let a newly diagnosed diabetic go on for weeks or months, eventually the immune system is going to pick off all of the remaining insulin-producing cells. However, when you're first diagnosed with diabetes you have anywhere from 10 to 30 percent of your insulin-producing cells still available, and we'd like to freeze it there. We'd like to stop the inflammatory process to prevent that 30 percent from declining any further because it's much, much easier to take care of the diabetes when the patient themselves is making adequate amounts of insulin. It's not enough to keep their own blood sugar normal but it makes it so much easier to treat and they're much less likely to have hypoglycemia, or dangerously low blood sugar," said Dr. Russell.

Abatacept is already approved to treat rheumatoid arthritis in children. The drug binds to a crucial trigger in the T cells of the immune system. Dr. Russell says the drug may harm the body's immune system, which is a risk they're closely monitoring. To be eligible for the trial patients must still be able to produce 10 to 30 percent of their own insulin.

FOR MORE INFORMATION:
Type 1 Diabetes TrialNet
1-800-425-8361
http://www.DiabetesTrialNet.org

Vanderbilt Type 1 Diabetes TrialNet
1-888-884-8638
http://www.VanderbiltDiabetesResearch.com