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Could Drug Treatment Before Diabetes Slow the Disease?

A researcher at Children’s Hospital in Pittsburgh is hoping to slow the progression of Type 2 diabetes by treating children before they get sick. The hospital will serve as one of six sites in a study that looks to be more proactive in the treatment of the illness.

“Give them medications to see if we can rest the pancreas and preserve the beta cell function and prevent the progression to full-blown or severe diabetes,” said principal investigator and University of Pittsburgh Pediatric Endocrinologist Silva Arslanian. 

The pancreas is responsible for producing insulin, and the beta cells store and release the insulin. In Type 2 diabetes patients, either the body does not produce enough insulin or the patients’ bodies build up immunity to the hormone.

The idea for the Restoring Insulin Secretion Study (RISE) comes out of the findings of an earlier study released this month that found children did not respond as well as adults to common forms of Type 2 treatment and that once the disease takes hold, it progress much faster in children.

“Let’s see if we can prevent this aggressive course of the disease and if we can preserve the beta cell production,” Arslanian said.

The study will enroll 11- to 18-year-old children who are either at risk of developing Type 2 diabetes or have been diagnosed with the illness in the last six months. Being overweight and inactive are the two biggest risk factors for Type 2 diabetes.

Participants will either get the drug metformin for a year or a three-month course of insulin followed by the oral medication. Researchers will then compare the two methods to see if there is an advantage to either course of pretreatment.

“The theory being that insulin might preserve the beta cell function,” Arslanian said.

The subjects will then be tracked for another seven months.

“It’s going to get to the mechanism of how we could preserve beta cell function,” said Arslanian, who thinks a larger trial will be launched if the findings are encouraging.

The same study that prompted the RISE study also lead the researchers to not bother adding a behavior modification education component. The first study found the addition of such education efforts result in little change to drug therapy outcomes.

The trial in Pittsburgh and one other site will involve juveniles while the other four sites will enroll adults.