Type 1 diabetes treatment could reduce need for insulin injections


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Human trials have begun on a new type 1 diabetes treatment that
could improve the lives of future sufferers of the disease.

Developed by scientists at the University of Cambridge, the
treatment could reduce a patient’s insulin injections from several
per day to potentially just a few times a week.

The immunological treatment slows damage to the pancreas,
meaning that newly diagnosed patients, in future, may be able to
retain the ability to produce insulin naturally.

“Our aim is […] to rebalance the immune system so that
patients can significantly reduce the number of insulin injections
needed to just once or twice a week by slowing the progression of
the disease,” 
says Frank Waldron-Lynch
, clinical study lead at the University
of Cambridge.


Type 1 diabetes
is caused when the body’s immune system attacks
insulin-producing cells in the pancreas. Around 400,000 people in
the UK suffer from the disease. Unlike type 2 diabetes, it is not
triggered by lifestyle factors like obesity.

Over the last ten years researchers at Cambridge, led by
Professor John
Todd
, have identified the IL-2 gene pathway as one of the
origins of the disease. The pathway codes the protein
“interleukin-2”, which controls the regulatory part of the immune
system.

Low levels of interleukin-2 result in an unbalanced immune
system, resulting in damage to the pancreas.

This damage reduces and eventually destroys the pancreas’
ability to create insulin, causing type 1 diabetes. Sufferers of
the disease require injections of artificial insulin on a regular
basis, usually before or after eating meals.

Waldron-Lynch and his colleagues, with support from the Wellcome
Trust, are investigating whether injections of interleukin-2, in
the form of a drug called aldesleukin, can slow the damage caused
by the immune system.

By preferentially boosting the regulatory part of the immune
system, he says, they hope patients will be able to retain the
ability to produce their own insulin, reducing the need for
artificial insulin injections.

It is unlike immunosuppression treatments, which dampen the
immune system generally. Injections of interleukin-2 simply boost
the number of regulatory T-cells.

The trial, run jointly by researchers at Addenbrooke’s Hospital
and Cambridge University’s Institute for Medical Research, began in
May and currently has six patients. Early results are positive,
with no side-effects detected, says Waldron-Lynch. The study aims
to find out what doses are most effective, and how regular
injections of the drug will need to be — once a week or once every
two weeks may be possible, he says.

The treatment will only be useful to patients in the early
stages of type 1 diabetes, up to two years after diagnosis, before
damage to the pancreas becomes too extensive. (The team are looking
for more patients to join the trial — more details
can be found here
).

Injections of interleukin-2 have also been investigated as a
possible way of treating graft-vs-host disease
, where the body
attacks stem cell or bone marrow transfusions, or other tissue
transplants.

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Advanced forms of long-lasting artificial insulin also reduce
the number of injections a patient needs to take, with one,
“degludec
“, allowing for injections only three times a week.
However, these long-lasting insulins don’t address the problem of
damage to the pancreas and have the potential side effect of
hypoglycaemia, or low blood sugar levels.