Type 1 Diabetes Research Spotlight | Bringing New Life to an Old Vaccine
June 23, 2018
Diabetes Researchers Leave No Stone Unturned
My whole life I had taken my pancreas for granted. That is until my now 2-year old daughter was diagnosed with type 1 diabetes (T1D) at 13 months, and myself, 3 months ago. I’ve since become fixated on and fascinated by the research advancements being made in attempt to mimic the meticulous 24/7 work of the pancreas. The most recent discovery demonstrates how one of the world’s oldest vaccines may have potential to regulate blood sugar.
Type 1 diabetes is an autoimmune disease where the body’s immune system mistakenly attacks and destroys the insulin-producing cells in the pancreas. Because the pancreas is no longer able to make insulin, type 1 diabetics must take replacement insulin—via an injection or insulin pump—every day and with every meal. The Bacillus Calmette-Guerin (BCG) vaccine, or TB vaccine has been used against tuberculosis for nearly 100 years. The connection between the two? Researchers at Massachusetts General Hospital found that adults with established T1D (at least 10 years) treated with the TB vaccine had blood sugar ranges return to near normal levels.
Eight-year follow-up results from a Phase I clinical trial were published yesterday in the journal NPJ Vaccine. After receiving 2 doses of the TB vaccine, about 50 people with T1D saw a delayed, yet significant drop in their long-term average blood sugar levels, which was sustained over the next five years of the study. And no cases of severe hypoglycemia (low blood sugar) were reported. Patients also saw their average A1C drop from 7.4% to 6.2%. A1C is an average measurement of blood sugar levels over a two-to three-month timeframe. The American Diabetes Association recommends an A1C of 7% or lower for diabetics. Lowering blood sugar and A1C reduces the risk of complications associated with diabetes, such as eye, kidney, and nerve damage.
How can a TB vaccine lower blood sugar? By eating sugar!
“[TB] changes the metabolism, and it eats sugar for its energy source,” Dr. Faustman, director of Mass General's immunobiology laboratory, explained. When BCG is administered to people with Type 1 diabetes, defensive white blood cells called lymphocytes gain an increased taste for sugar too; they switch their normal energy consumption habits to a process called aerobic glycolysis, which allows them to “eat more sugar for energy.” BCG may even play a role in “re-training” the immune system to stop attacking insulin-producing cells.
Is this a cure? Not quite yet. Patients still needed to take insulin. However, less may be needed, and blood sugars may be more controlled. Research is still in its early stages to draw any finite conclusions, but it offers hope for easier management of this unpredictable, relentless disease.
My dream is for a cure during my daughter’s lifetime, so that she can experience life without the constant anxiety over blood glucose numbers.
Take time today to thank your pancreas!
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