Oral Drug for Type 1 Shows Lasting Benefits

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Oral Drug for Type 1 Shows Lasting Benefits

Taking verapamil, an oral blood pressure drug, was shown to reduce insulin requirements for people with type 1 diabetes for at least two years, according to a new study published in the journal Nature Communications.

In addition to looking for an elusive cure for type 1 diabetes, a great deal of research in recent years has explored ways to delay the onset of type 1, slow the progression of the disease, or improve blood glucose control right away in people with a recent diagnosis. One recent study showed that a management approach involving intensive diabetes education and wearing a continuous glucose monitoring (CGM) system improved blood glucose control in children with recently diagnosed type 1 diabetes — an important result because early blood glucose control is linked to long-term outcomes, like the risk for diabetic complications down the road. When it comes to delaying the progression of type 1 — often defined as preserving the body’s own insulin production, even at reduced levels, for as long as possible — taking a vitamin D supplement may be helpful in combination with standard insulin therapy, one recent study showed. And for people known to be at high risk for type 1 diabetes, an immunotherapy drug called teplizumab has been shown to help delay diagnosis of the condition by a couple of years in typical cases.

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For the latest study, researchers were interested in whether taking verapamil could have an effect on insulin requirements in people with type 1 diabetes. A previous study, published in 2018, had shown that this drug could potentially help people with type 1 produce more of their own insulin — meaning that it might both improve blood glucose control and reduce the need for outside insulin, as noted in a news release on the latest study at the University of Alabama at Birmingham. The new study tracked a small group of participants over two years, with regular blood tests to look at their own insulin production and other indicators of how the drug might help with type 1 diabetes management.

Verapamil linked to lower insulin requirements in type 1

The researchers found that participants who took verapamil for the entire two years consistently required less insulin than members of a control group that didn’t take the drug, while participants who stopped taking the drug after one year saw their insulin requirements increase to more or less match the control group. Blood tests also showed that taking verapamil was linked to changes in a number of proteins related to autoimmunity in type 1 diabetes — the immune system’s attack on insulin-producing beta cells in the pancreas. In fact, 53 different proteins appeared to have their abundance altered by taking verapamil. The protein that was most affected by taking the drug is known as chromogranin A (CHGA), and it is known to be elevated around the time of the onset of type 1 diabetes. In people who took verapamil, the levels of CHGA were significantly lower than in the control group that didn’t take the drug.

“In humans with type 1 diabetes, even a small amount of preserved [internal] insulin production — as opposed to higher [external] insulin requirements — has been shown to be associated with improved outcomes and could help improve quality of life and lower the high costs associated with insulin use,” said study author Anath Shalev, MD, director of the Comprehensive Diabetes Center at the University of Alabama at Birmingham, in the news release. “The fact that these beneficial verapamil effects seemed to persist for two years, whereas discontinuation of verapamil led to disease progression, provides some additional support for its potential usefulness for long-term treatment.”

Want to learn more about type 1 diabetes? Read “Type 1 Diabetes Questions and Answers,” “Six Type 1 Diabetes Symptoms You Need to Know” and see our type 1 diabetes videos.

Quinn Phillips

Quinn Phillips

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A freelance health writer and editor based in Wisconsin, Phillips has a degree from Harvard University. He is a former Editorial Assistant for Diabetes Self-Management and has years of experience covering diabetes and related health conditions. Phillips writes on a variety of topics, but is especially interested in the intersection of health and public policy.

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