Anti-diabetic human clinical trials are underway in 2018

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Diabetes is, without doubt, the new global epidemic. According to the World Health Organization (WHO), there were 1.5 million of deaths worldwide from diabetes in 2012. This disease can result in high blood glucose, obesity, cardiovascular-related disease, blindness and premature death.

In answer to this modern plague, the diabetes drug market has never been this robust. Pharmaceutical companies and medical organizations are in cut-throat competitions to develop and test curative therapies for this ‘silent killers.’ Though there hasn’t been any groundbreaking approved treatment, several are showing such promise that their human trials are to be underway in 2018.

1. Oral anti-diabetic drug developed by Singapore

Left to right: Associate Professor Teoh Yee Leong, Professor Lee Kok Onn, Associate Professor Sim Meng Kwoon. (c) Singapore Clinical Research Institute (SCRI)

After 20 years of research, the Department of Pharmacology at the National University of Singapore Yong Loo Lin School of Medicine (NUS Medicine) has successfully developed DAA-1, an anti-diabetic drug that is taken orally. Phase I of the trial was conducted on 18 healthy individuals from 24 to 47 years old. No harmful effects were detected.

Normally, insulin is released to regulate the transportation of blood glucose into cells. The insulin pathway is created, in which insulin-receptors signal transporting cells to bind to glucose in the blood and bring them out to cells for energy usage or storage. In type 2 diabetic patients, the insulin pathway malfunctions. As a result, glucose can’t move into cells and stay in the bloodstream.

DAA-1 is designed to induce the production and action of insulin and tackle all the four spots that can go wrong in the insulin pathway. What’s more, the drug also prevents chronic inflammation caused by diabetes, as well as reduces the rate at which pancreatic beta cells – those that produce insulin – die.

Further studies to test the efficacy of DAA-1 are scheduled in 2018. Yet the success of Phase I has already been a hopeful sign for diabetic treatments in Singapore in particular and Southeast Asia in general.

2. Tissue transplant reversed diabetes in mice

A rat in which researchers grew mouse pancreas. (c) Courtesy of the Nakauchi lab

Researchers at the Stanford University School of Medicine and the Institute of Medical Science at the University of Tokyo collaborated on the successful interspecies transplantation of pancreatic tissues that reversed diabetes in mice.

First, researchers implanted mice pluripotent stem cells (that can become any kind of cells) into the embryos of rats engineered to be unable to develop pancreases. Once those rats had matured, researchers extracted their pancreatic beta cells and implanted onto matched mice. These mice had been given drugs in advance to induce them to develop diabetes.

The results were fascinating. Experimented mice only took immunosuppressive drugs for 5 days to prevent cell rejection and remained completely well for the next 370 days. The implanted pancreatic cells also reversed diabetes in mice with an initial intake of only 100 cells. No signs of tumor or abnormalities were found.

This finding raised hope not only for treating diabetes but also for any organ transplantation. If this regime works in human and ethical issues are resolved, we can develop human organs in animals to tackle the shortage of organ donation for patients that need transplantation.

3. Vaccine for type 1 diabetes

Those with type 1 diabetes have pancreatic beta cells mistakenly destroyed by the immune system. Consequently, their bodies can’t produce insulin to take glucose out of the bloodstream. This condition, often developed in the early years of childhood, was found to be associated with a type of virus called coxsackievirus B1 (CVB1).

In their 2014 study, virologist Heikki Hyöty and his team at the University of Tampere found that less than 5% of children having CVB1 developed type 1 diabetes. This meant hundreds of children around the world annually; and if other viruses in the CVB group contributed to the disease, the number could go up.

Pre-clinical trials were done and the results were promising in mice. Another eight years might go by before we can reach the final conclusion, yet there is hope. The vaccine obviously can’t cure diabetes, but if it works, a great number of cases will be reduced.

In addition, the CVB1 vaccine can also prevent infections caused by enteroviruses such as the common cold, myocarditis, meningitis and hand, foot and mouth diseases. Clinical trials on human are going to be conducted in 2018.

Up to this point, diabetes still remains an incurable disease that attacked 422 million people worldwide in 2014. However, efforts are being restlessly made to fight this disease. With innovative treatments such as the three aforementioned cases, we have all the rights to look forward to victory.