September 10, 2015

Diabetes trial targets body’s ability to produce insulin

Kiersten Eaddy had long looked forward to her high school graduation day and joining her classmates to celebrate the accomplishment.

Kiersten Eaddy had long looked forward to her high school graduation day and joining her classmates to celebrate the accomplishment.

But when that day rolled around last May, the 18-year-old from Deatsville, Alabama, found herself on the way to the local emergency room, and later flown to UAB Hospital in Birmingham.

Instead of accepting her diploma, Eaddy learned she had type 1 diabetes.

Kiersten Eaddy is taking part in a clinical study that seeks to determine whether drug therapy can preserve the pancreas’ ability to produce insulin in patients diagnosed with type 1 diabetes. (photo by Susan Urmy)

Now Eaddy is among a group of patients participating in a study at Vanderbilt University Medical Center aimed at learning whether drug therapy can preserve the ability of the pancreas to continue producing some insulin in newly diagnosed patients with type 1 diabetes.

Vanderbilt is one of 21 institutions cooperating in the study, which focuses specifically on the impact of two drugs: anti-thymocyte globulin and granulocyte CSF.

Researchers have theorized that the drugs used together could slow or halt the progression of the disease and preserve the remaining insulin-producing beta cells.

Type 1 diabetes, formerly called juvenile diabetes, is an autoimmune disease that attacks the body’s ability to make insulin, which controls blood glucose levels.

By the time the illness is diagnosed in most patients, significant damage has been done to the beta cells that produce insulin. Eventually, most people with the disease become completely unable to produce insulin.

That’s why preserving the insulin-producing beta cells could lessen the severity of the disease. It could also allow patients to avoid episodes of low blood sugar, another effect that can happen to patients using insulin.

“If this combination of drugs works, the therapy could hold a lot of promise not only for newly-diagnosed type 1 diabetes patients, but also for people much earlier in the disease process, when there is only evidence of autoimmunity, but minimal damage to the beta cells,” said William Russell, M.D., Cornelius Vanderbilt Professor of Pediatrics and director of Pediatric Endocrinology and Diabetes at Monroe Carell Jr. Children’s Hospital at Vanderbilt.

“Even if it can’t reverse the already-extensive beta cell damage, it could make a huge difference by just preserving some degree of insulin secretion,” Russell said. “Not enough to keep their blood sugar normal without insulin treatment, but much easier to manage.”

Eaddy is the sixth to join in the trial, but more participants are needed, Russell said.

“This particular study is one of the most exciting in the network, focused as it is on trying to eliminate the clones of immune cells that are focused on destroying the beta cells,” Russell said.

“The mission of TrialNet is far more ambitious: to prevent the development of type 1 diabetes by halting the progression of the immune attack when it is first identified and before there has been any significant loss of beta cells.”

For Eaddy, the signs that she had developed the disease were there before graduation day. For weeks, she was tired and experienced increased thirst and appetite. Her clothes started not to fit well and the teenager shed weight quickly during a short time period.

After she was transported to UAB, Eaddy spent four days at the hospital recuperating from ketoacidosis, a condition common in untreated type 1 diabetes, where the body has trouble breaking blood glucose.

The now 19-year-old college freshman studies biology at UAB and wanted to participate in a trial to help researchers understand the disease better.

“I really wasn’t thinking about this benefiting me but people in the future,” she said. “I really want to help them gain knowledge.”

To Russell and his TrialNet colleagues, Kiersten’s altruism is heartening.

“We meet the most incredible people in our work — people who recognize that they may not benefit directly from participating in the prevention research, but who want to make a difference for the next generation in their family and others. Kiersten’s attitude encourages us to press on, to not let her or the other participants down. There is too much at stake,” Russell said.

The study is seeking participants between 12 to 45 years old, diagnosed with type 1 diabetes less than 3 months before screening for the trial. Individuals between the ages of 1 and 45 can be screened for type 1 diabetes risk if they have a blood relative with the disorder.

For more information about this study or to be screened for type 1 diabetes risk, contact the Vanderbilt TrialNet team at 888-884-8638 or diabetesresearch@vanderbilt.edu, or visit the website at www.vanderbiltdiabetesresearch.com.