Could Type 2 Diabetes Drug Benefit Teen and Young Adult Type 1 Diabetics?

BUFFALO, N.Y. -- University at Buffalo researchers whose small, preliminary study last year found that liraglutide, used to treat type 2 diabetes, could also help type 1 diabetics, have been awarded a $600,000 grant from the American Diabetes Association to further study the drug in type 1 diabetics.

If the UB team's initial findings are confirmed in this larger, prospective, randomized study, they could mean the first significant, new treatment for type 1 diabetes since insulin was discovered and made available in the 1920s.

The researchers, led by Paresh Dandona, MD, PhD, UB distinguished professor of medicine and the chief of the Division of Endocrinology, Diabetes and Metabolism in the School of Medicine and Biomedical Sciences, have been awarded an ADA Clinical/Translational Research Award to study "Anti-diabetic effects of liraglutide in adolescents and young subjects."

The ADA study, which will last for three years, is designed to study how the addition of the injectable medication, liraglutide (marketed as Victoza), will impact the blood sugar levels of teenage and young adult type 1 diabetic patients currently treated with insulin alone.

The researchers are currently recruiting 45 type 1 diabetes patients, ages 15 to 30 years. For more information, contact the research staff at 716-887-4486.

The goal, says Dandona, is to address what he calls "the tragedy of the type 1 diabetic," because since the development of injectable insulin, there have been no further definitive advances for treating the disease.

"This pivotal project has the potential of enhancing therapy for type 1 diabetes in adolescents, where diabetes control is traditionally difficult," say Dandona's UB co-investigators Teresa Quattrin, MD, A. Conger Goodyear Professor and Chair of the Department of Pediatrics, housed in Women and Children's Hospital of Buffalo; Antoine Makdissi, MD, assistant professor of medicine; and Lucy D. Mastrandrea, MD, PhD, assistant professor of pediatrics. Quattrin is chief of the department's Division of Pediatric Endocrinology and director of the hospital's Diabetes Center.

The ADA grant was awarded following the publication last summer in the European Journal of Endocrinology by Dandona and co-authors of research demonstrating that liraglutide in type 1 adult diabetics results in "a significant and rapid reduction in glycemic fluctuations and, as a consequence, a rapid reduction in the amount of insulin they needed to take," Dandona explains. In addition, there was a significant reduction in body weight (4.5 Kg, or 10 pounds) over a period of six months.

That finding was made in a small group of type 1 diabetic adults whose glucose levels were already very well-controlled, but who, like most type 1 diabetics, nevertheless experience significant hyperglycemic and hypoglycemic fluctuations or excursions.

"The action of liraglutide in patients with type 2 diabetes is largely due to an increase in insulin secretion from the pancreas,," Dandona explains, "But since type 1 diabetics have no insulin secretion, our preliminary study demonstrated that in these patients, liraglutide's effect was independent of insulin secretion."

He says that liraglutide's benefit in such patients may be due to the suppression of glucagon, a hormone that raises glucose levels. An abstract, based on this work, presented at the Endocrine Society in Boston in 2011 was judged as the best in the field of diabetes.

Dandona also is leading research, funded by a $400,000 grant from Novo-Nordisk Pharmaceuticals, which manufactures Victoza, to investigate the relationship between the dose of liraglutide and the quality of blood sugar control in type 1 diabetics.