Is a Type 1 Diabetes Cure Right Around the Corner?


For lack of a better phrase, those who have type 1 diabetes -- a form of diabetes whereby the person's own autoimmune system attacks or attempts to destroy cells in the pancreas responsible for producing insulin -- often get the short end of the stick.

Despite being the most common chronic disease in children, type 1 diabetes accounts for just 5% of all diabetes diagnoses. The remaining 95% are type 2 diabetics who see their glycemic imbalance brought upon because of a number of factors including genetic make-up, and a number of behavioral habits like smoking or obesity caused by poor diet or lack or exercise. With the pendulum swinging so decisively toward type 2 diabetes in number of diagnoses, it's not surprising to see so many pharmaceutical companies focusing their efforts on developing new type 2 medications.

That pendulum, though, may be ready to swing back in the other direction.

In one of the more exciting studies I've witnessed over the past few years, a research team at Boston Children's Hospital released its findings via a blog post last week that it had discovered the pathway responsible for causing type 1 diabetes. After testing hundreds of different pathways in animals, researchers, identified the ATP/P2X7R pathway as the one responsible for triggering T-cell attacks on the pancreas that render it incapable of producing insulin.

It's all about treating the symptoms

Source: Sarah G., Flickr.

As of right now, the primary treatment option associated with type 1 diabetes is insulin, as well as maintaining a healthy lifestyle through proper diet and exercise. Insulin comes in various forms, from the rapid-acting type to longer-lasting insulins.

Eli Lilly's Humalog, for example, is one of the most widely used rapidly acting insulins. Its duration time is only three to five hours, but it'll peak in effectiveness in as little as 30 minutes. It was also responsible for $2.4 billion, or 11%, of Eli Lilly's total pharmaceutical sales last year and works well if taken while a meal is being consumed.

On the other end of the spectrum is Sanofi's Lantus, which is a once-daily injection that can work in the body for up to 20-24 hours, but can also be combined with a short-acting insulin if needed. Lantus has been an absolute blockbuster diabetes drug up until now, garnering worldwide sales of more than $6 billion in 2012.

Another big beneficiary from type 1 diabetes is glucose-monitoring device makers. Perhaps the most exciting product in this space is Bayer's Contour Next Link. Bayer has partnered its device with Medtronic in such a way that it'll connect wirelessly to Medtronic's insulin pump, drastically reducing many instances of human error or forgetfulness, and delivering the right dosage of insulin to patients throughout the course of the day.

Soon, we may be curing the disease
But, the truth of the matter is that these are treatments for the symptoms associated with type 1 diabetes; they aren't cures. The research conducted at Boston Children's Hospital offers the possibility of an actual cure if a medication can be developed that suppresses autoimmune dysfunction based on this specific pathway. Admittedly, we could be looking at half a decade or longer before there's a big enough human trial to validate whether a cure can be derived, but this is exciting news nonetheless.

It would also make a lot of sense for a company like Eli Lilly or Sanofi to lead the way in terms of type 1 diabetes research, as Lilly's Humalog is set to lose patent protection next year and Sanofi's patents will expire in 2014/2015. These two pharmaceutical giants would love to replace the revenue that's almost certain to be lost because of generic competition. Building upon Boston Children Hospital's research could be one way of accomplishing this.

While we're still quite a ways from a cure, type 1 diabetes patients certainly have a reason to be a little more hopeful as it appears researchers are now one step closer.

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