Antivirals ‘could save insulin-producing cells in children with type 1 diabetes’

Antiviral drugs could help preserve the function of insulin-producing cells in children newly diagnosed with type 1 diabetes, new research suggests.

These cells, the beta cells of the pancreas, normally malfunction and die during this condition.

Type 1 diabetes is normally diagnosed during childhood, and there is no cure for it.

In people with the condition, the body attacks its own beta cells and destroys its capacity to produce insulin – leaving people dependent on insulin for the rest of their lives.

The scientists say their findings support the idea that a low-grade persistent virus infection could be linked to the condition occurring, and that type 1 diabetes may be prevented by the development of new vaccines.

They add that the study sets the stage for further research into the ideal antivirals – medications that normally help your body fight off viruses – to be used alone, or as part of combination treatment, to rescue insulin producing beta-cells.

The study was conducted by Dr Ida Maria Mynarek, and principal investigator Professor Knut Dahl-Jorgensen, Oslo University Hospital, Norway, and colleagues.

The authors say: “Among children with newly diagnosed type 1 diabetes, a 26-week course with two antiviral drugs partially preserved stimulated C-peptide secretion 12 months after diagnosis and a higher proportion of participants with clinically relevant preserved C-peptide secretion than placebo.

“These results provide a rationale to find optimal antiviral drugs to be used alone, or as part of combination treatment regimens, to rescue insulin producing beta-cells at diagnosis of type 1 diabetes.

“Further studies should be done at an earlier stage in the disease process to evaluate whether antiviral treatment could delay the progression of beta-cell damage leading to clinical type 1 diabetes.

“This study supports that a low-grade persistent virus infection is an underlying disease mechanism, and that type 1 diabetes may be prevented by development of new vaccines.”

Girl with type 1 diabetes giving herself a finger prick blood sugar test
People with the condition are left dependent on insulin for the rest of their lives (Alamy/PA)

In the phase 2 trial, 96 children (aged six to 15) were randomly assigned to receive oral antiviral treatment (pleconaril and ribavirin), or a dummy drug (placebo) for six months, started less than three weeks after a diagnosis of diabetes.

Researchers found that after a year, C-peptide levels – which exactly mirror the insulin production in the pancreas – were significantly higher in the antiviral group than in the placebo group.

The level fell 24% in the placebo group, and only 11% in the treatment group.

According to the findings, 86% of the children in the treatment group and 67% in the placebo group had maximal C-peptide levels above a cut-off that signifies a residual insulin production.

Researchers say this is important because it makes it easier to treat the patient with insulin, and it has also been shown to reduce long-term complications of diabetes.

The treatment was safe and no severe adverse events occurred.

The study, published in Nature Medicine, is affiliated with the INNODIA consortium which addresses research, prevention and a cure of type 1 diabetes.

The findings were presented at the annual meeting of the European Association for the Study of Diabetes (EASD) in Hamburg, Germany.