‘First Step’ Toward Delaying Progression of Type 1 Diabetes
'First Step' Toward Delaying Progression of Type 1 Diabetes
Tzield (teplizumab), is the first disease-modifying therapy for individuals at-risk for developing T1D was recently approved by the FDA or use in people 8-years and older who are at risk for developing type 1 diabetes (T1D).
This new medication addresses the autoimmunity behind the development of T1D and can delay progression for an average of two years in people who are at risk and in the stage 2 phase of developing TID.
This breakthrough treatment was possible due to the participation of over 200,000 relatives of people with T1D from our clinic and others around the world who participated in the TrialNet program over the past 20 years.
Relatives of people with T1D have a 15 times higher risk of developing the disease and studying this group led to the understanding that T1D developed in three stages. Stage 1 is when the immune system starts attacking insulin-making beta cells, stage 2 is when an individual has two or more diabetes-related antibodies and blood glucose levels becomes higher into the prediabetes range and stage 3 occurs after significant beta-cell loss that leads to the clinical diagnosis of T1D.
Nearly all of the people identified as having two or more diabetes-related antibodies go on to develop T1D in their lifetime and this group was considered an ideal target for an intervention to delay or stop progression. However, all the research that has been done is in people under the age of 45 and we don’t know the risks of progression in older individuals. It also does not work in people who have already been diagnosed with T1D (those who have Stage 3, T1D.)
The Tzield intervention is the first successful treatment that can be administered to delay the progression and other trials are ongoing to develop treatments that can further slow or stop T1D. The drug is given as a daily infusion for 14 consecutive days. One treatment course costs $200,000. At present we can not give the drug in our clinic, but if demand grows we may be able to create an infusion center in our new office area.
Guidelines for who should be screened to receive the treatment are still being developed. There are currently three ways to be screened to determine if an individual is in the stage 2 treatment window. Relatives of people with T1D can qualify for free screening and access to current trials through TrialNet, there is an at-home test for $55 available through Enable BioSciences and screening is available through the clinic.
We would all love a cure for type one diabetes, or at least an ability to completely prevent progression to T1D. But this is the first time ever we've been able to slow the progression of pre-type 1 diabetes to actual type 1 diabetes.
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