Changing the standards of care for T1D

Three different therapies that improve outcomes for people with type 1 diabetes

New results from JDRF-supported research show how three different therapies can improve life with type 1 diabetes (T1D). The results were announced last week at the 53rd annual meeting of the European Association for the Study of Diabetes (EASD) in Lisbon, Portugal. The EASD meeting is one of the biggest diabetes conferences on the calendar, and this year was no exception, with results from several high-profile trials being announced. Read on for highlights!

Better outcomes in T1D pregnancies with CGM use

On Friday, results from the JDRF-funded CONCEPTT trial were presented and simultaneously published online in The Lancet. This landmark trial evaluated outcomes associated with the use of continuous glucose monitoring (CGM) during pregnancy in women with T1D. Results showed that CGM use improved glycemic control in mothers-to-be, boosting time in range by about 100 minutes per day. Notably, CGM also benefited their babies, lessening the risk of complications and the need for intensive care and shortening hospital stays by about a day. This is the first study to show the potential for CGM to positively influence non-glycemic health outcomes, and JDRF is proud to have championed this work. We hope the results will encourage the use of CGM in women with T1D, particularly during pregnancy, and advance to new and improved standards of clinical care.

SGLT inhibition improves multiple health measures

On Wednesday, Lexicon Pharmaceuticals shared new data from ongoing clinical trials of its unique dual SGLT inhibitor sotagliflozin. SGLT inhibitors are drugs that help to avoid high blood-sugar levels by increasing excretion of glucose via urine. The new results show that sotagliflozin not only reduced HbA1c in adults with T1D but also improved other key health measures, such as time in range, body weight and blood pressure, without increasing hypoglycemia. It is so exciting to see trials acknowledging the importance of outcomes in addition to HbA1c for people with T1D.

JDRF supported earlier work with this drug, including a clinical study in young adults with T1D with high HbA1c. Results of that study were promising and JDRF has remained engaged with Lexicon Pharmaceuticals to support their development program in various ways.

Lexicon has indicated plans to submit sotagliflozin for regulatory review and approval in the U.S. and Europe in early 2018. Sotagliflozin will be the first therapy of its kind developed for T1D first, rather than type 2 diabetes, and JDRF is excited about the potential benefits of this class of drugs for our community. The primary investigator on the trial believes this drug has the potential to become a first-in-class therapy in the treatment paradigm for T1D.

Metformin reduces cardiovascular and kidney complications

There is good news about repurposed medications, too, metformin being perhaps the most studied. On Tuesday, JDRF-funded researchers on the REMOVAL trial announced that further analyses seemed to confirm the initial findings, reported in June at the ADA Scientific Sessions, that metformin reduced risk of cardiovascular and kidney complications in individuals with long-standing T1D (average 33 years) and several of the risk factors for cardiovascular disease. The research team hopes further work will help to identify who will benefit most from using metformin in addition to insulin therapy and guide clinical practice regarding the use of metformin in T1D. They also postulated that earlier intervention with metformin could offer additional protection from complications of the heart and kidney.

Improving beta cells for replacement therapies

Last week’s meeting also featured the EASD/JDRF Symposium, which focused on the generation of stem cell-derived beta cells for therapeutic use in people with T1D. While we have made great strides forward on this front over the past few years, certain challenges remain, and JDRF is committed to addressing them to further the development of beta cell replacement therapies for T1D. This symposium allowed researchers to share ideas on surmounting the remaining challenges to produce more consistent, well characterized and more functional beta cells for use in potential cell replacement strategies.

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By Monica Harrington