Di­a­betes study tests whether in­sulin in pills could pre­vent the dis­ease

Cape Breton Post - - ADVICE/LIESTYLES -

For nearly a cen­tury, in­sulin has been a life-sav­ing di­a­betes treat­ment. Now sci­en­tists are test­ing a tan­ta­liz­ing ques­tion: What if pills con­tain­ing the same medicine pa­tients in­ject ev­ery day could also pre­vent the dis­ease?

Thir­teen-year-old Hay­den Mur­phy of Plain­field, Illi­nois, is help­ing re­searchers de­ter­mine if the strat­egy works for Type 1 di­a­betes, the kind that is usu­ally di­ag­nosed in child­hood. If it does, he might be able to avoid the life­time bur­dens fac­ing his 5-year-old brother, We­ston. They in­cludes count­less fin­ger pricks and blood sugar checks, and avoid­ing play­ing too hard or eat­ing too lit­tle, which both can cause dan­ger­ous blood sugar fluc­tu­a­tions.

Hay­den Mur­phy is among more than 400 chil­dren and adults par­tic­i­pat­ing in U.S. gov­ern­ment-funded in­ter­na­tional re­search in­ves­ti­gat­ing whether ex­per­i­men­tal in­sulin cap­sules can pre­vent or at least de­lay Type 1 di­a­betes. Hos­pi­tals in the United States and eight other coun­tries are in­volved and re­cruit­ment is on­go­ing. To en­rol, par­tic­i­pants must first get bad news: re­sults of a blood test show­ing their chances for de­vel­op­ing the dis­ease are high.

“When I got the news, I was dev­as­tated,’’ Hay­den said. He knows it means his life could change in an in­stant.

“He has the daily re­minders. He sees what his brother goes through,’’ said the boys’ mom, Myra Mur­phy.

So now Hay­den Mur­phy swal­lows a small white capsule daily and has his blood checked pe­ri­od­i­cally for signs of di­a­betes.

“I hope it doesn’t come to me, and I re­ally didn’t want it to come to him,’’ Hay­den said.

A small, pre­lim­i­nary study by dif­fer­ent re­searchers, pub­lished re­cently in the Jour­nal of the Amer­i­can Med­i­cal As­so­ci­a­tion, sug­gests the ap­proach might work. Chil­dren who took in­sulin pills showed im­mune sys­tem changes that the re­searchers said might help pre­vent di­a­betes. The study was too small and didn’t last long enough to know for sure.

The on­go­ing larger study is more rig­or­ous, ran­domly as­sign­ing par­tic­i­pants to get ex­per­i­men­tal in­sulin cap­sules or dummy pills, and should pro­vide a clearer an­swer.

“Does it pre­vent in­def­i­nitely? Does it slow it down, does it de­lay di­a­betes? That also would be a pretty big win,’’ said Dr. Louis Philip­son, a Univer­sity of Chicago di­a­betes spe­cial­ist in­volved in the study.

About 1.25 mil­lion Amer­i­cans have Type 1 di­a­betes. Type 2 dis­ease is more com­mon, af­fect­ing nearly 30 mil­lion na­tion­wide and most of the more than 300 mil­lion world­wide with di­a­betes. Be­sides short-term com­pli­ca­tions from poorly con­trolled blood sugar, both types raise long-term risks for dam­age to the kid­neys, heart and eyes.

Both types are in­creas­ing and for Type 2, ex­perts think that’s be­cause of ris­ing obe­sity and in­ac­tiv­ity. But the up­ward trend in Type 1 di­a­betes, in­creas­ing world­wide by at least 3 per cent each year, is more per­plex­ing.

“We know so very lit­tle about the ex­act mech­a­nisms that cause Type 1 di­a­betes,’’ which com­pli­cates ef­forts to pre­vent it, said Dr. Desmond Schatz, the study’s chair and med­i­cal di­rec­tor of the Univer­sity of Florida Di­a­betes Cen­ter.

“For the most part, it’s re­ally shoot­ing an arrow into a field and hop­ing one of the ar­rows hits a tar­get,’’ Schatz said.

In Type 1 di­a­betes, the pan­creas stops mak­ing in­sulin, a blood sugar-reg­u­lat­ing hor­mone that helps the body con­vert sugar in food into energy. Treat­ment is life­time re­place­ment in­sulin, usu­ally via in­jec­tions or a small pump. In Type 2, the body can’t make proper use of in­sulin. It can some­times be treated with a healthy diet and ex­er­cise.

Genes are thought to in­crease risks for Type 1 di­a­betes. Viruses and other in­fec­tions are among fac­tors sug­gested as pos­si­ble trig­gers the dis­ease, which causes the body’s im­mune sys­tem to at­tack in­sulin-pro­duc­ing cells.

Dr. Wendy Brick­man, a di­a­betes spe­cial­ist at Chicago’s Lurie Chil­dren’s Hos­pi­tal who’s in­volved in the study, ex­plained that re­searchers think tak­ing in- sulin by mouth so that it’s di­gested like food might some­how trick the faulty im­mune sys­tem into not at­tack­ing in­sulin-mak­ing cells.

In­sulin pills also are be­ing stud­ied as a di­a­betes treat­ment, but the chal­lenge has been find­ing a way to get the drug to reach the blood­stream with­out be­ing de­graded as it is di­gested.

A branch of the Na­tional In­sti­tutes of Health is fund­ing the preven­tion re­search, in­clud­ing two other stud­ies: one in­volves in­fu­sions of the drug Oren­cia, ap­proved for rheuma­toid arthri­tis, another au­toim­mune dis­ease; the other in­volves in­fu­sions of an ex­per­i­men­tal drug called teplizumab.

If preven­tion pills work, they’d likely be less ex­pen­sive than hav­ing a life­time of di­a­betes, said Lisa Spain, an in­sti­tute sci­en­tist and pro­gram di­rec­tor.

AP PHOTO

We­ston Mur­phy, 5, who has Type 1 di­a­betes, pricks his fin­ger to test his blood at his home in Plain­field, Ill. His old­est brother is among more than 400 chil­dren and adults par­tic­i­pat­ing in U.S. gov­ern­ment-funded in­ter­na­tional re­search in­ves­ti­gat­ing whether ex­per­i­men­tal in­sulin cap­sules can pre­vent or at least de­lay Type 1 di­a­betes.

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