We take a look at some of the exciting diabetes research developments announced in July, and what the findings could mean for people living with or affected by diabetes.
In this month's article:
- Targeting new type 1 treatments for their full potential
- Reassurance on eating disorder risks in type 2 remission programmes
- Resistant starch could smooth blood sugar spikes
Targeting new type 1 treatments for their full potential
Teplizumab is an exciting new immunotherapy treatment that can weaken the immune system’s attack and slow down the development of type 1 diabetes when used in the early stages of the condition, before symptoms appear. It’s currently under review for use in the UK. Meanwhile, scientists are working to understand who could benefit the most from it.
A new paper, published in the Journal of Diabetes and its Complications, brings together what we’ve learned from teplizumab clinical trials so far.
Type 1 diabetes isn’t the same for everyone. Research we’ve funded has helped us identify two distinct patterns in how type 1 diabetes develops. The first subtype, which scientists have named T1DE1, is seen in children who are diagnosed with type 1 in their early childhood. It’s characterised by a more aggressive immune system attack, where beta cells are destroyed more rapidly. The other subtype – T1DE2 – is seen in people diagnosed with type 1 in their teens or later in life. Here, there are fewer attacking immune cells and a slower loss of beta cells.
Researchers found that these underlying differences in how the immune system attacks might influence how well teplizumab works. They saw that it seems to be most effective at holding back the full development of type 1 diabetes when given to children under 15. And particularly those who have the more aggressive T1DE1 subtype.
They think this is because teplizumab works by calming down the specific attacking immune cells that are more active in T1DE1. Teplizumab may weaken the immune attack enough that it starts behaving more like it does in T1DE2.
The researchers say that future immunotherapy clinical trials should be designed with these subtype differences in mind.
We’re excited about the potential of teplizumab and other immunotherapies, and are funding research and working closely with the NHS to make sure they reach everyone who could benefit as soon as possible. By deepening our understanding of who will benefit most from teplizumab and when, based on their specific type 1 subtype, we can ensure it’s used in the most effective and targeted way.
Reassurance on eating disorder risks in type 2 remission programmes
New research has helped us better understand the risk of eating disorders for people taking part in type 2 diabetes remission programmes.
Following the landmark results of our DiRECT trial, the NHS rolled out the Type 2 Diabetes Path to Remission Programme. Tens of thousands of people living with type 2 diabetes and overweight or obesity have now taken part. The programme supports people to lose weight, helping to ‘reboot’ the pancreas, using a low-calorie ‘soups and shakes’ diet with support.
However, there have been concerns that such programmes, which involve a focus on weight and strict diets for a short period, could increase the risk of eating disorders.
A new study from researchers at the University of Oxford has now found this isn’t the case. They showed that remission programmes do not increase the risk of eating disorders in people living with type 2 diabetes and overweight or obesity, even among those already showing signs of disordered eating.
The study involved 56 people. Half followed a 12-week ‘soups and shakes’ diet, with remote behavioural support, followed by guided food reintroduction and weight maintenance advice. The other half received usual type 2 diabetes care.
By 6 months, those in the soups and shakes group lost almost 14kg on average. Importantly, researchers didn’t find an increase in eating disorder symptoms and no new cases of eating disorders were identified. Those in the soups and shakes group even showed a slight improvement in disordered eating behaviours.
This is reassuring evidence that, when delivered with the right support, low-calorie diet remission programmes are not only effective, but safe even for people who may be more vulnerable to eating problems.
Resistant starch could smooth blood sugar spikes
New research suggests that swapping a small portion of regular starch for resistant starch in everyday meals could help people with type 2 diabetes better manage their blood sugar levels.
Regular starch is quickly broken down into glucose, which can cause blood sugar levels to shoot up. Resistant starch – found naturally in some foods like green bananas – isn’t digested in the same way. It travels to the gut where it’s broken down more slowly.
Previous research has shown resistant starch can reduce blood sugar spikes in people without diabetes. But we hadn’t known whether it could offer the same benefits for people with type 2.
Researchers at the University of Surrey studied 20 people with type 2 diabetes who followed two different meal plans for four days each. The meals looked and tasted the same, but in one version, 15% of the regular starch was replaced with resistant starch. Participants wore continuous glucose monitors to track their blood sugar levels.
The results showed that the resistant starch meals led to lower peaks in blood sugar after meals (up to 0.9 mmol/L lower) and on average 6% more time spent in target blood sugar range. And the swap didn’t affect the taste of the food.
This small study highlights the potential of resistant starch as a simple approach to help people with type 2 diabetes manage blood sugar levels and reduce their risk of complications. Further research is now needed, with more people and over a longer period.
