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Antiviral drugs could maintain beta cell function in children newly diagnosed with type 1 diabetes

A clinical trial funded by JDRF suggests that treating children with antiviral drugs when they are first diagnosed with type 1 diabetes could preserve their ability to produce some insulin.
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Kate Lawton 5 October 2023
A graph from the research paper showing that the people with type 1 diabetes who took the antiviral drugs had higher levels of C-peptide (insulin production) than those on the placebo.

A graph from the research paper showing that the people with type 1 diabetes who took the antiviral drugs had higher levels of C-peptide (insulin production) than those on the placebo.

The research, published in the journal Nature Medicine , shows that the antiviral drugs pleconaril and ribavirin could help preserve the function of the insulin-producing beta cells of children newly diagnosed with type 1. Treatment with these drugs could help protect beta cells, which are normally destroyed by the immune system of people with type 1 .

The link between viruses and type 1

Studies have found a link between infection with a type of virus called enterovirus and the onset of type 1. The JDRF-funded team behind this clinical trial also detected low levels of enterovirus infection in the pancreases of people newly diagnosed with type 1. This growing evidence of a link between enteroviruses and type 1 led the researchers to test whether antiviral drugs could be used to treat people with type 1.

The clinical trial

Based in Norway, the research team gave 47 children aged 6-15 years an oral mixture of two antiviral drugs, pleconaril and ribavirin. Meanwhile, 49 children were given a placebo. To keep the test fair, neither the children taking part, nor the researchers knew who was taking the which mixture.
The children began the experiment within three weeks of being diagnosed with type 1 and took the mixture for six months. After 12 months, the researchers measured their C-peptide levels, which is a measure of insulin production.

The results of the clinical trial

The C-peptide levels of the group who were taking the antiviral drugs was significantly higher than the group taking the placebo. The amount of insulin the children taking the placebo could produce dropped by 24% in the 12 months since their diagnosis. By contrast, the insulin production of the children taking the antiviral drugs only fell by 11% in the same period. This suggests that the antiviral drugs were preserving some of the children’s residual insulin production.

Why is residual insulin production important?

Being able to produce some insulin helps make managing type 1 easier. It has also been shown to reduce long term complications of diabetes.

Also known as the honeymoon period, people with type 1 who are still making some insulin may need to take less insulin and experience more stable blood glucose levels. Preserving this ability is especially important for the young age group in this study, whose changing bodies can make managing type 1 even harder.

No negative side effects

None of the children in this study experienced any severe side effects from the antiviral drugs. They also didn’t experience any severe hypos in the 12 months they were studied. The lack of serious side effects suggests that it is safe to give children newly diagnosed with type 1 the antiviral drugs pleconaril and ribavirin.

Clinical trial led by JDRF-funded researchers

JDRF-funded researcher Professor Knut Dahl-Jørgensen from Oslo University Hospital led the clinical trial and presented the results at Europe’s largest diabetes conference.

Professor Dahl-Jørgensen said: “These results provide a rationale to find optimal antiviral drugs to be used alone, or as part of combination treatment regimens, to rescue insulin producing beta-cells at diagnosis of type 1 diabetes. Further studies should be done at an earlier stage in the disease process to evaluate whether antiviral treatment could delay the progression of beta-cell damage leading to clinical type 1 diabetes.”

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