Teplizumab Offers New Hope for Type 1 Diabetes Prevention

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  • Teplizumab Marks Breakthrough in Preventing Type 1 Diabetes Onset.
  • UK Treats First Adult with Early Type 1 Diabetes Using Teplizumab.
  • Shifting the Type 1 Diabetes Paradigm: Treating Before It Starts.

For over a century, living with type 1 diabetes has meant one thing: a lifetime of insulin shots. But now, science is turning that idea on its head, not by just managing the disease, but by catching it before any symptoms show up, reports Science Alert.

A New Chapter in Diabetes Treatment

The UK has started treating its first patients with teplizumab, an innovative therapy that takes a proactive stance on type 1 diabetes. Unlike the usual approach, which kicks in after symptoms appear, this medication is administered before any signs of the disease.

At Royal Devon NHS, the first adult in the UK to receive teplizumab is Hannah Robinson, who discovered she had early-stage type 1 diabetes during a routine pregnancy check-up.

Understanding the Disease

Type 1 diabetes is an autoimmune disorder that destroys the insulin-producing cells in the pancreas. Without insulin, blood sugar levels can spike dangerously high, leading to serious complications like blindness, kidney failure, and even premature death.

While many think of it as a childhood illness, research from the University of Exeter reveals that more than half of new cases occur in adults.

The Burden of Insulin Therapy

For millions living with type 1 diabetes, treatment means a lifetime of daily insulin injections. However, insulin therapy comes with its own set of risks.

If blood sugar levels drop too low, it can result in hypoglycemia, or “hypos,” which in severe cases can lead to seizures or even death. During pregnancy, Robinson experienced the daily struggle firsthand: “Life completely revolves around balancing your blood glucose.”

How Teplizumab Works

Teplizumab takes a fresh approach to treatment. Rather than just replacing insulin, it focuses on the immune system that mistakenly attacks the pancreas. Normally, the immune system is pretty good at telling the difference between the body’s cells and harmful invaders. However, in autoimmune conditions like type 1 diabetes, this system can get confused.

Teplizumab works by retraining the immune system, calming down the specific immune cells that go after insulin-producing cells. Research indicates that this drug can postpone the onset of the disease and the need for insulin therapy by two to three years, with side effects that are generally mild. For Robinson, this delay is a game-changer. “The possibility of a few extra years without insulin really mattered.”

Approved in the US, Under Review in the UK

Teplizumab has already received approval in the US and is currently being reviewed for routine use by the NHS in the UK. Some children and teenagers there have already been able to access it through special programs.

Catching the Disease Early

One big hurdle we face is that for teplizumab to really work, it needs to be administered before any symptoms pop up. By the time someone starts experiencing signs like thirst, fatigue, or weight loss, more than 75% of their insulin-producing cells have already vanished.

Early Detection Through Blood Tests

The good news is that we can now spot early signs of autoimmune activity with a straightforward blood test that checks for pancreatic autoantibodies.

Even a simple finger prick can reveal if the immune system has started to attack the pancreas. This early detection not only paves the way for preventive treatments but also helps steer clear of emergencies like diabetic ketoacidosis when the diagnosis is made.

Who Should Be Tested?

About 1 in 200 people are impacted by type 1 diabetes, but the risk isn’t the same for everyone. While some inherited conditions stem from a single gene, type 1 diabetes is influenced by multiple genes and various unknown environmental factors.

Interestingly, nine out of ten individuals who develop type 1 diabetes don’t have a family history of it. Testing relatives of those with type 1 diabetes is a sensible first step, but recent research from the University of Exeter suggests that creating a combined genetic risk score could help pinpoint at-risk infants and enhance genomic screening efforts down the line.

Toward an Insulin-Free Future

We’re still in the early stages, but this represents a significant change in how we tackle type 1 diabetes.

For over a hundred years, patients have had to deal with the daily challenge of replacing the insulin their bodies can no longer produce. Now, the spotlight is shifting toward immune-targeting therapies that aim to halt the disease before it fully takes hold.

The vision is clear: to pave the way for a future without the need for insulin.

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Source: Science Alert