UB to Expand Study on Potential Treatment for Type 1 Diabetes

If the initial findings on liraglutide are confirmed in the larger study, it could mean the first significant new treatment for Type 1 diabetes since insulin’s discovery in the 1920s.

The three-year prospective, randomized study will examine how the addition of injectable liraglutide—marketed as Victoza—impacts blood sugar levels of teenagers and young adults currently treated for Type 1 diabetes with insulin alone.

Paresh Dandona, MD, PhD, UB distinguished professor of medicine and the chief of the Division of Endocrinology, Diabetes and Metabolism, is principal investigator.

Teresa Quattrin, MD, A. Conger Goodyear Professor and Chair of the Department of Pediatrics, is a co-investigator.

“This pivotal project has the potential to enhance therapy for Type 1 diabetes in adolescents, where blood sugar control is traditionally difficult,” says Quattrin, who is also chief of the department’s Division of Pediatric Endocrinology and director of the Diabetes Center at Women and Children’s Hospital of Buffalo.

The American Diabetes Association awarded the grant to Dandona after he and his co-authors published the article “Liraglutide as Additional Treatment in Type 1 Diabetes” in the European Journal of Endocrinology. The paper described how administration of liraglutide in Type 1 adult diabetics results in a significant and rapid reduction in glycemic fluctuations and a subsequent rapid reduction in the amount of insulin they need.

The paper also reported a significant reduction in subjects’ body weight over a six-month period.

The findings were made in a small group of people whose glucose levels were already very well-controlled, but who, like most Type 1 diabetics, nevertheless experience significant hyperglycemic and hypoglycemic fluctuations or excursions.

“The action of liraglutide in patients with Type 2 diabetes is largely due to an increase in insulin secretion from the pancreas,” Dandona explains. “But since Type 1 diabetics have no insulin secretion, our preliminary study demonstrated that in these patients, liraglutide’s effect was independent of insulin secretion.”

Dandona notes that liraglutide’s benefit in such patients may be due to the suppression of glucagon, a hormone that raises glucose levels. An abstract based on this work was presented at the Endocrine Society in 2011 and judged best in the field of diabetes.

In addition to Quattrin, co-investigators on the study are Antoine Makdissi, MD, clinical assistant professor of medicine, and Lucy D. Mastrandrea, MD, PhD, assistant professor of pediatrics.

Dandona also is leading research to investigate the relationship between the dose of liraglutide and the quality of blood sugar control in Type 1 diabetics. That research is funded by a $400,000 grant from Novo Nordisk Pharmaceuticals, which manufactures Victoza.