Emerging Treatments for Type 1 Diabetes

This blog is designed to give people living with type 1 diabetes information about investigational treatments so that they can keep themselves informed about ongoing research and development in therapies. 

If you are interested in knowing more about managing type 1 diabetes in daily life, you can read more here. 

What is Type 1 Diabetes?

Type 1 diabetes (T1D) is a condition where the body’s immune system attacks and destroys the insulin-producing cells of the body – the beta (β) cells of the pancreas. 

The insulin produced by these cells is crucial for transporting glucose (sugar) from the bloodstream into cells, where it is used for energy. Without enough insulin, glucose remains in the blood, leading to high blood sugar levels and depriving cells of the energy they need to function properly.¹  

Untreated type 1 diabetes, for example due to delay of a diagnosis, can be life-threatening due to an acute complication called diabetes-related ketoacidosis (DKA).²  

How is Type 1 Diabetes Treated? 

The current standard treatment for type 1 diabetes involves insulin administration, which regulates blood sugar levels. Additionally, people living with type 1 diabetes may be required to make several lifestyle and dietary adjustments to ensure blood sugar levels are managed effectively.³  

In some circumstances, a whole pancreas transplant may be considered, with the objective being the person would not need to take insulin anymore. However, pancreas transplants are only indicated in specific cases and there are potential risks associated with the procedure.⁴ However, there are a few specialised centres in North America, parts of Europe, and Australia, which offer an experimental procedure involving the transplantation of only the insulin-producing cells from a donor’s pancreas to a patient – this is called a pancreatic islet transplant – which can reduce the risks of this procedure.^4,5

Despite these type 1 diabetes treatments, significant challenges remain: 

• Insulin treatment is a lifelong necessity. It is part of effective management of the disease, alongside other lifestyle adjustments. 

• Whole pancreas transplant is a complex procedure, there is a limited supply of donor organs and both whole pancreas and pancreatic islet transplants need lifelong immunosuppression. Additionally, islet transplant remains experimental.  

This highlights the importance of developing new treatments to enhance the quality of life for those with type 1 diabetes. 

Emerging therapies 

Researchers are actively exploring novel therapeutic approaches with the objective of preventing or reversing type 1 diabetes. The following therapies are still in the investigational stages, with ongoing research and clinical trials needed to evaluate their safety and effectiveness. 

Immunotherapy  

Immunotherapy is the treatment of disease by stimulating or suppressing an immune response. In the treatment of type 1 diabetes, this means using approaches to prevent the immune system from attacking the insulin-producing cells in the pancreas and aiming at stopping or reversing damage to those cells. An example of immunotherapy is the use of antibodies, proteins made by the immune system to fight infections. In laboratories, scientists are working on modifying these antibodies so they can specifically target and deactivate the immune cells that attack and destroy the insulin-producing cells in the pancreas.⁶  

Cell encapsulation 

Cell encapsulation is another experimental approach for transplanting insulin-producing cells into people with type 1 diabetes without needing them to take immunosuppressive drugs. This technique involves using semi-permeable membranes (thin biological sheets that allow certain molecules to pass through more easily) to protect transplanted cells from being attacked by immune system while allowing nutrients and oxygen to pass through. Notably, this technique is still investigational, with ongoing clinical trials assessing its safety and effectiveness.⁶ 

Stem cell transplantation  

Stem cells are special cells in the body that can be obtained from different sources in the body and that have the ability to develop into many different cell types. Through scientific measures, it is possible to turn stem cells into continuously dividing cell lines. This means that cells from a single donor can give rise to trillions more.⁷ During stem cell transplantation, these stem cells are introduced to an individual with the objective of replacing damaged cells. In type 1 diabetes, this approach might help restore insulin-producing cells. Importantly, this approach remains investigational, with ongoing clinical trials evaluating its safety and effectiveness.⁶ 

Gene therapy 

Gene therapy refers to the insertion of genes into cells to correct genetic abnormalities or improve the function of cells. In the case of type 1 diabetes treatment, gene therapy might be used to insert genes that boost the growth and survival of insulin-producing cells or to silence genes that contribute to their destruction.^6,7  

It is however important to note that gene therapy for type 1 diabetes is still in the early experimental stages, with a significant portion of the research being conducted in the laboratory 

Some clinical trials are exploring combinations of these techniques, such as immunotherapy, gene therapy, cell encapsulation and stem cell transplantation, in order to try to maximize potential advantages of these approaches. For example, one innovation involves combining cell encapsulation and stem cell transplantation. In this technique, stem cells are encapsulated in devices designed to shield them from the immune system. This approach addresses two major problems: 

1. It provides an unlimited supply of insulin-producing cells by using stem cells.
2. Encapsulation protects these cells from the immune system, eliminating the need for immunosuppression.

 This combination seeks to utilize the strengths of both approaches, which could potentially enhance the effectiveness of stem cell therapies for type 1 diabetes.⁸  

Conclusions 

Current treatment of type diabetes involves lifelong administration of insulin. The common goal of diabetes type 1 alternative treatments currently in development is to improve the quality of life of people suffering from this condition. Some of these new developing treatments include immunotherapy, gene therapy, cell encapsulation, and stem cell transplantation. Combining these techniques could enhance their effectiveness. However, more investigation in clinical trials is needed to confirm their efficacy and safety. 

Are you affected by type 1 diabetes and want to explore clinical trials? 

Visit this page to learn more about clinical trials in type 1 diabetes:  

At myTomorrows, we have a team of Patient Navigators who are medically trained, multi-lingual professionals, who help you to explore your treatment options and support you through your journey.  

You can book a call with a Patient Navigator to discuss your options and learn more about participating in clinical trials.