This blog is a collection of smaller news items about T1D.
COVID Not Likely to Increase T1D in Children
From the beginning of COVID there has been an expectation that T1D rates would go up because COVID would either "cause" or "trigger" T1D.
(I might be splitting hairs by separating "causing" and "triggering", but in my mind, these are two different things. If X causes Y, that means that if the person avoids X they will never get Y. That X takes a healthy person and they get Y. On the other hand, X triggers Y, means that the person was always likely to get Y, and X changed the timing so that the person got Y right then, but they still would have gotten Y eventually, even if X had not happened. I think there is widespread agreement that many illnesses "trigger" a diagnosis of T1D, but the question of weather they "cause" T1D is very much open.)
In any case, this research suggests that T1D diagnosis rates did go up, but not because of COVID, but rather because of changes in behavior due to the lock down.
From the article:
More children and adolescents than usual developed type 1 diabetes in Finland in the first 18 months of the coronavirus pandemic. According to a recently completed study, the cause was not the novel coronavirus, but altered environmental factors.
According to the study, the incidence of type 1 diabetes increased in children in Finland by 16% in the first 18 months of the pandemic. However, very few children or adolescents who developed type 1 diabetes had SARS-CoV-2 antibodies indicating a past infection.
According to the researchers, the increase in the incidence of type 1 diabetes in the early stages of the pandemic is not likely to have been caused directly by coronavirus. Instead, it may be related to the society-wide lockdown in the pandemic period and the resulting social isolation.
"According to what is known as the biodiversity hypothesis, microbial exposure and infections in early childhood can boost the protection against autoimmune diseases. The reduction in contacts in connection with the societal lockdown significantly reduced acute infections in children, which may have increased the risk of developing diabetes," Knip [one of the paper's author's] explains.
Combination of GABA and GAD Unsuccessful in Phase-II Trial
I previously blogged on this study here: https://cureresearch4type1diabetes.blogspot.com/2018/08/gaba-starts-phase-ii-clinical-trial-in.html
Summary of results from the abstract:
The primary outcome, preservation of fasting/meal-stimulated c-peptide, was not attained. Of the secondary outcomes, the combination GABA/GAD reduced fasting and meal-stimulated serum glucagon, while the safety/tolerability of GABA was confirmed. There were no clinically significant differences in glycemic control or diabetes antibody titers. ... although GABA alone or in combination with GAD-alum did nor preserve beta-cell function in this trial.
The paper: https://www.nature.com/articles/s41467-022-35544-3
The Trial Registration: https://clinicaltrials.gov/ct2/show/NCT02002130
Discussion
This is a classic example of "slow publishing means bad results". The study finished in 2019, but the results were not published until 2022.
Also, this is not good news for GAD, which Diamyd has been testing for many years. One group of this study got GABA and GAD, but did no better than the control group. If GAD were effective, you would expect to see some good effect in this group.
Abatacept Unsuccessful at Preventing the Onset of T1D
I previously blogged on this study here: https://cureresearch4type1diabetes.blogspot.com/2020/04/possible-cures-for-type-1-in-news-april.html
Summary of results:
This trial of 1-year treatment with abatacept in participants with stage 1 type 1 diabetes did not show a statistically significant effect on progression to stage 2 or stage 3 type 1 diabetes.
This was a 200 person study (half got Abatacept, half got a placebo), for people at-risk of T1D (called "stage 1"). These are people with two or more autoantibodies, so the assumption is that they will move to abnormal blood glucose tests ("stage 2") and then diagnosis of T1D ("stage 3"), as the disease progresses. The goal was to delay this progression.
News Article: https://www.hcplive.com/view/abatacept-misses-mark-for-preventing-type-1-diabetes-in-phase-2-trial
Journal Article: https://diabetesjournals.org/care/article/doi/10.2337/dc22-2200/148547/Abatacept-for-Delay-of-Type-1-Diabetes-Progression
Note to the T1D Community: https://www.trialnet.org/our-research/completed-studies/abatacept
Trial Registry: https://clinicaltrials.gov/ct2/show/NCT01773707
Discussion
Abatacept has been tested in several different clinical trials going back at least 15 years. In a case of unfortunate timing, researchers in Australia started a new Abatacept study about 3 weeks before the unsuccessful results of this study were announced:
https://www.clinicaltrials.gov/ct2/show/NCT05742243
The Australian study is enrolling people who have been diagnosed with T1D, while the earlier study was enrolling people who had 2 autoantibodies, but no abnormal blood sugar tests, and no other symptoms. So it is possible that one would be successful even though the other has failed, but I think it is a "long shot".
