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Therapies to Preserve beta-Cell Function in Type 1 Diabetes
Linköping University, Department of Clinical and Experimental Medicine, Division of Clinical Sciences. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center of Paediatrics and Gynaecology and Obstetrics, Department of Paediatrics in Linköping.
2016 (English)In: Drugs, ISSN 0012-6667, E-ISSN 1179-1950, Vol. 76, no 2, 169-185 p.Article in journal (Refereed) PublishedText
Abstract [en]

In spite of modern techniques, the burden for patients with type 1 diabetes mellitus will not disappear, and type 1 diabetes will remain a life-threatening disease causing severe complications and increased mortality. We have to learn of ways to stop the destructive process, preserve residual insulin secretion or even improve the disease via beta-cell regeneration. This will give a milder disease, a more stable metabolism, simpler treatment and perhaps even cure. Therapies based on single drugs have not shown sufficient efficacy; however, there are several treatments with encouraging efficacy and no apparent, or rather mild, adverse events. As the disease process is heterogeneous, treatments have to be chosen to fit relevant subgroups of patients, and step by step efficacy can possibly be improved by the use of combination therapies. Thus immunosuppressive therapies like anti-CD3 and anti-CD20 monoclonal antibodies might be combined with fusion proteins such as etanercept [tumor necrosis factor (TNF)-alpha inhibitor] and/or abatacept (CTLA4-Ig) early after onset to stop the destructive process, supported by beta-cell protective agents. The effect may be prolonged by using autoantigen therapy [glutamate decarboxylase (GAD) proinsulin], and by adding agents facilitating beta-cell regeneration [e.g. glucagon-like peptide-1 (GLP-1)] there should be a good chance to make the disease milder, perhaps leading to cure in some patients.

Place, publisher, year, edition, pages
ADIS INT LTD , 2016. Vol. 76, no 2, 169-185 p.
National Category
Clinical Medicine
Identifiers
URN: urn:nbn:se:liu:diva-124627DOI: 10.1007/s40265-015-0511-xISI: 000368159400002PubMedID: 26645223OAI: oai:DiVA.org:liu-124627DiVA: diva2:901795
Note

Funding Agencies|Diamyd Medical

Available from: 2016-02-09 Created: 2016-02-08 Last updated: 2016-02-09

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Ludvigsson, Johnny
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Division of Clinical SciencesFaculty of Medicine and Health SciencesDepartment of Paediatrics in Linköping
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