Type 1 diabetes (T1D), previously known as juvenile diabetes, affects approximately 1.25 million American children and (much less commonly) adults. Unlike the much more common type 2 diabetes, which is largely related to lifestyle, T1D is an autoimmune disease it results from a malfunction of the body s own immune system, which causes it to attack and destroy insulin-producing cells in the pancreas. While the causes of T1D are not fully understood, it is known that genes play a role, and exposure to certain infectious diseases is thought to play a part as well.
Researchers led by Dr. Ezio Bonifacio, PhD, from the DFG Center for Regenerative Therapies Dresden in Germany, have taken a big step in creating what could be a vaccine to prevent this disease. The researchers objective was to assess if oral exposure to insulin at the right doses would train the immune system to tolerate insulin, thus preventing the autoimmune response.
Their study, published in JAMA, included 25 children aged 2-7 years with a strong family history of type 1 diabetes. Fifteen children were randomized to receive various doses of oral insulin, while the 10 others received a placebo once daily for 3 to 18 months. At the highest insulin dosage (67.5 mg), the insulin powder was found to induce the desired immune response: 5 of the 6 children (83.3 percent) treated with this dosage showed a positive immune response, compared to 20 percent of children who received a placebo.
Feeding insulin to children who have a high genetic risk for starting the process that eventually leads to type 1 diabetes can actually have a vaccine-like effect that tickles the immune system of these children in a way that we think is protecting them from getting type 1 diabetes, Dr. Bonifacio explained. He added that his team was pleased to see there were no unwanted side effects.
While the results show promise, there is more research to be done. In the future, the researchers plan to conduct another trial in a larger group of children. And eventually, they hope to study whether the response from giving children insulin can prevent type 1 diabetes.
ACSH s Dr. Josh Bloom, who was formerly a researcher in diabetes says, What makes this especially interesting is the oral dosing. Insulin is a protein, which are digested (much like food) in the stomach. This is why protein medications must be injected (sometimes inhaled) rather than swallowed. Scientist have been working on oral insulin forever, but haven t yet solved the problem. So how can it work? The researchers believe that the insulin is acting in the mouth, not the stomach. This is not so far fetched. A number of drugs are administered under the tongue, or through the cheek, where they are absorbed directly into the blood. Very interesting stuff.