In Type I diabetes, also known as juvenile diabetes, the immune system attacks pancreatic cells that make insulin, a hormone involved in blood-sugar regulation. Patients first start to experience symptoms such as excessive thirst and increased urination after most of these cells have already been destroyed. Once diagnosed, patients become dependent on receiving insulin externally, through injections or a pump. However, since those newly diagnosed still have some remaining insulin-producing cells, researchers have long questioned how to prevent their complete destruction. Researchers studied whether using an antibody treatment that counters the immune system's attack on these pancreatic cells could help preserve insulin production and make patients less dependent on external insulin.

What the researchers wanted to know: Can antibody treatment preserve insulin-producing cells in patients with newly diagnosed Type I diabetes?

What they did: Researchers randomly divided 80 patients recently diagnosed with Type I diabetes into two groups. One group received an antibody treatment intravenously while the other group received a placebo solution. The researchers recorded insulin doses and evaluated how well the patients' pancreatic cells produced insulin at the beginning of the study and also at six, 12, and 18 months following the treatments. They documented the side effects during and after treatment.

What they found: In the 18 months following the treatments, patients who received the placebo needed more insulin and had a decrease in the functioning of their insulin-producing cells. By contrast, in patients receiving the antibody treatment, their insulin-producing cell function and daily insulin doses were similar at the beginning and end of the study. Significantly, patients who responded the most to the antibody treatment were those who started the study with better functioning insulin-producing cells. During and after the therapy, the patients who received the antibodies were more likely to develop side effects, including headaches, fever, joint aches, and rash.

What it means to you: While insulin is the current treatment for Type I diabetes, this trial points toward a future where different treatments may contribute to disease management for those newly diagnosed. Also, since blood tests are now available to identify those who are at higher risk of developing Type I diabetes, the antibody therapy may potentially be used to counter pancreatic cell destruction before the disease sets in.

Caveats: Since the specifics of each case are different, similar results may not be expected for all patients newly diagnosed with Type I diabetes. Also, since the trial lasted for only 18 months, it is unclear if the treatment could "wear off" after a certain period of time. Lastly, since all patients receiving the antibodies experienced side effects, more studies are needed to document the treatment's safety.

Find out more: The National Institutes of Health has a page with information on symptoms, diagnosis, and treatment of Type I diabetes.

Juvenile Diabetes Research Fund International has an online support team for newly diagnosed patients and their families.

Read the article: Keymeulen, B., et al. "Insulin Needs After CD3-Antibody Therapy in New-Onset Type 1 Diabetes." New England Journal of Medicine. June 23, 2005, Vol.352, pp. 2598-2608.

Abstract online: http://content.nejm.org