Type 2 drugs: Life-changing for Type 1 diabetes

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People with Type 1 diabetes need artificial insulin to survive. Without it, they can go blind, lose a limb or develop life-threatening kidney problems or heart disease.

That is why the search for new drugs and better treatments is critically important.

Instead of waiting years for new drugs to come through the pipeline, researchers are now testing old drugs and getting results.

As president of a car dealership, Eric Rehkemper is a busy man. He stays cool under pressure, all while managing type one diabetes.

"It's a 24-7, seven days a week, whether you're on vacation or whether you're working the job," Rehkemper said. "It's something that always factors into everything you're doing."

The only approved drug to keep Type 1 diabetics alive is insulin, but it's dangerously easy to over- and underdose.

"Insulin is difficult and risky and challenging," Washington University endocrinologist Dr. Janet McGill said.

The treatments for Type 1 and Type 2 diabetes are different. But doctors are now trying Type 2 drugs in Type 1 patients.

"What these drugs offer is a little reprieve from doing everything perfectly just with insulin," McGill said.

One class of Type 2 drugs called GLP-1 receptor agonists lower insulin doses and improve blood sugars. Another class called SGLT-2 inhibitors significantly lower blood sugar levels for many Type 1s.

"It reduces some of the very high blood sugars that occur after meals," McGill said.

SGLT-2 inhibitors also improve heart and kidney health.

"Some get quite noticeably good results," McGill said.

Rehkemper has seen big improvements in his blood sugar by taking an SGLT-2 inhibitor along with his insulin.

"It has been such a great improvement on my body. Probably added 10, 15 years to my life," he said.

Another common drug for Type 2 diabetes, metformin has also shown to reduce insulin needs for some Type 1 diabetics while improving blood sugar control.

It's important for patients with Type 1 diabetes to discuss the pros and cons of each of these drugs to determine if any of them are an appropriate addition to their current treatment.

MEDICAL BREAKTHROUGHS
RESEARCH SUMMARY
TOPIC: TYPE 2 DRUGS: LIFE CHANGING FOR TYPE 1 DIABETES
REPORT: MB #4620

BACKGROUND: Millions of people around the world live with diabetes or know someone living with diabetes. The majority have type 2 diabetes, but an important minority have type 1 diabetes. Contrary to popular belief, type 1 diabetes is not a childhood disease. It occurs at every age, in people of every race, and of every shape and size. In fact, there are more adults who have type 1 diabetes than children, although it was previously known as juvenile diabetes. In type 1 diabetes, the body does not produce insulin. Through multiple daily injections with insulin pens or syringes or an insulin pump, it is up to the monitor their blood glucose levels and appropriately administer insulin. (Source: http://www.diabetes.org/diabetes-basics/type-1/)

INSULIN OVERDOSE: Cold sweats, trembling hands, intense anxiety, a general sense of confusion -- these are signs of low blood sugar. It is also called hypoglycemia. It often happens when you take too much insulin. More symptoms include extreme hunger, fatigue, and irritability. This typically happens when the syringes or vials are misread, when the wrong type of insulin is used, when insulin is injected right before exercise, or when insulin is taken but the patient has not eaten. Its important to keep a consistent schedule and eat something at every mealtime. But researchers are looking for more drug options to help those with type 1 diabetes. (Source: https://www.webmd.com/diabetes/insulin-overdose#2)

DRUGS FOR TYPE 1 DIABETES: Janet McGill, MD, an endocrinologist at Washington University St. Louis said, "The SGLT2 inhibitors have been tested in type 1 diabetes and there are a couple findings. One is that it reduces some of the very high blood sugars that occur after meals. Patients feel quite good on them. Sotaclofosin was presented to the FDA after a couple of large clinical trials in type 1 diabetes. And the advisory committees split. The FDA declined to approve sotoclofosin for use in type 1 diabetes. But there are four others actually. So we don't know the outcome,what the FDA will say about the others." (Source: Janet McGill, MD)