The cause of type-1 diabetes is still unknown with many factors at play but none conclusive. Scientists have however learned that type 1 diabetes begins years before it is diagnosed when a person’s own immune system launches subtle attacks on the beta cells in the pancreas. In a recent study, Herold et al. 2019, discovered that the an anti-CD3 antibody, Teplizumab, originally intended to protect new organs after kidney transplantation, could deactivate T cells that are targeting insulin producing beta cells.   This study investigated people who were at high risk of developing type-1 diabetes (have a first degree relative with type-1) but had not yet been diagnosed.  Using a double-blind randomized method, participants were assigned a single 14-day course of Teplizumab or placebo and follow-up tests for progression to type-1 diabetes were performed at 6-month intervals.  The results showed that a single dose of Teplizumab delayed progression of type-1 diabetes by approximately two years in those at risk of developing type-1 diabetes.   This is a ground-breaking study as previously there was no tangible method of preventing, or in this case delaying, type-1 diabetes for high risk individuals.   Further investigation of Teplizumab will raise an interesting ethical debate as the findings from this study have proven delayed onset of Type-1 diabetes, and therefore trial design using placebo might be denying participants, particularly children age 12 and below, the opportunity for a delay in a type-1 diabetes clinical diagnosis.

The full research article published in the New England Journal of Medicine can be found here