Researchers at St Vincent’s Institute of Medical Research (SVI) in Melbourne have shown that a commonly prescribed rheumatoid arthritis drug can suppress the progression of type 1 diabetes. The Health Pioneer shares the details

The world-first human trial led by SVI’s Professor Thomas Kay, has shown that a drug called baricitinib can safely and effectively preserve the body’s own insulin production and suppress the progression of type 1 diabetes in people who initiated treatment within 100 days of diagnosis.

“When type 1 diabetes is first diagnosed there is a substantial number of insulin-producing cells still present. We wanted to see whether we could protect further destruction of these cells by the immune system. We showed that baricitinib is safe and effective at slowing the progression of type 1 diabetes in people who have been recently diagnosed,” said Professor Kay.?

This ground-breaking research shows promise as the first disease-modifying treatment of its kind for type 1 diabetes that can be delivered as a tablet.

“It is tremendously exciting for us to be the first group anywhere in the world to test the efficacy of baricitinib as a potential type 1 diabetes treatment,” said Professor Kay.

“Up until now, people with type 1 diabetes have been reliant on insulin delivered via injection or infusion pump. Our trial showed that, if started early enough after diagnosis, and while the participants remained on the medication, their production of insulin was maintained. People with type 1 diabetes in the trial who were given the drug required significantly less insulin for treatment.”

Management of the lifelong autoimmune disease is incredibly burdensome on those diagnosed and their families, requiring meticulous glucose monitoring and insulin administration day and night to stay alive.

Up until insulin’s discovery more than 100 years ago, type 1 diabetes was a fatal condition. Despite insulin’s life-saving role, the therapy itself is potentially dangerous if too much or too little is administered, and the condition still comes with long-term complications, including heart attack and stroke, vision impairment, kidney disease and nerve damage.

“We are very optimistic that this treatment will become clinically available. This would be a huge step-change in how type 1 diabetes is managed and we believe it shows promise as a fundamental improvement in the ability to control type 1 diabetes,” said Professor Helen Thomas.

The clinical trial was funded by JDRF, advocacy and community programs organisations and research organisations including  The Royal Melbourne Hospital, St Vincent’s Hospital Melbourne, The Royal Children’s Hospital and The Women’s and Children’s Hospital in Adelaide.

STATUS IN INDIA

There is a registry maintained by the Indian Council of Medical Research called as the Young Diabetes Registry (YDR) since year 2006. The YDR registry recruits patients with young onset diabetes, diagnosed on or before 25 years of age. The registry operates at 205 centres from 10 cities across India. According to the YDR registry data, out of 20351 young diabetes patients recruited, 13368 (65.6%) were type 1 diabetes. According to the 10th International Diabetes Federation Atlas 2021, the number of children with type 1 diabetes in India is 22,94,000 in the age group of 0 - 19 years.

A sub study from the ICMR-YDR registry say that the average annual incidence of type 1 diabetes (below 20 years) is 4.9 cases/1,00,000 populations.