{"id":35376,"date":"2014-02-20T09:42:40","date_gmt":"2014-02-20T14:42:40","guid":{"rendered":"http:\/\/asweetlife.org\/?post_type=feature&#038;p=35376"},"modified":"2016-01-10T05:43:28","modified_gmt":"2016-01-10T10:43:28","slug":"type-2-diabetes-treatments-may-benefit-people-with-type-1-diabetes","status":"publish","type":"post","link":"https:\/\/asweetlife.org\/?p=35376","title":{"rendered":"Type 2 Diabetes Treatments May Benefit People with Type 1 Diabetes"},"content":{"rendered":"<p style=\"text-align: justify;\">\n<p style=\"text-align: justify;\">Recent breakthroughs in type 2 diabetes treatments promise new treatment options for type 1 diabetics. Navigating this world of new, and apparently improved drugs, however, is anything but simple or straightforward.<\/p>\n<p style=\"text-align: justify;\">Less than 20 years ago, the only thing type 1 and type 2 diabetes seemed to have in common was a shared name; they were related conditions but only as distant cousins, and once removed, at that. The paradigm at the time was that type 1 and type 2 diabetes required different treatments because they were, in fact, very different conditions. In type 1 diabetes the pancreas stops making insulin so type 1 diabetics injected insulin to replace what the body was no longer producing. Type 2 diabetes, however, was a condition in which a person\u2019s pancreas was producing insulin, but their body was not metabolizing and using the hormone efficiently. Type 2 diabetics took oral medications to help improve their ability to metabolize the insulin their bodies were producing.<\/p>\n<p style=\"text-align: justify;\">It turns out things aren\u2019t so straightforward. The recently realized realities regarding the ways each condition evolves and behaves has led to new ways of treating each type of diabetes and a sharing of therapies between the two.<\/p>\n<p style=\"text-align: justify;\">Doctors and researchers discovered the last decade that, for a variety of reasons, many type 2 diabetics could benefit from taking insulin.<\/p>\n<p style=\"text-align: justify;\">\u201cUnfortunately, many people with type 2 diabetes experience progressive loss of beta cell function,\u201d according to Robert Tanenberg, MD, FACP, who <a href=\"http:\/\/diabeteshealth.com\/read\/2009\/03\/20\/5564\/insulin-for-type-2-diabetes-who-when-and-why\/\" target=\"_blank\">wrote about why type 2 diabetics were increasingly turning to insulin as a treatment option.<\/a> \u201cTheir overworked beta cells seem to burn out, and drugs that were once effective can no longer hold their A1c&#8217;s below 7%.\u201d<\/p>\n<p style=\"text-align: justify;\">There are numerous causes for this, according to Andrea Penney, RN, CDE, with the Joslin Diabetes Center. \u201cSometimes the pancreas becomes unable to produce enough insulin,\u201d Penney says. \u201cThis happens frequently with aging. People can also become insulin resistant due to weight gain or chronic emotional or physical stress. Simply put, pills can no longer control diabetes.\u201d<\/p>\n<p style=\"text-align: justify;\">That change in thinking about the ways type 2 diabetes evolves indirectly opened the door to considering new ways of thinking about how type 1 diabetes behaves. That shift led to considering whether that door swung both ways and if type 1 diabetics might benefit from treatments designed to treat type 2 diabetes.<\/p>\n<p style=\"text-align: justify;\">There is only one treatment besides 54 varieties of insulin approved by the Federal Drug Administration for use by type 1 diabetics, according to the University of Maryland Medical Center, and that drug is pramlintide acetate, which is marketed under the name Symlin.<\/p>\n<p style=\"text-align: justify;\">Pramlintide is a small peptide hormone produced in the pancreas and, in people without diabetes, is released alongside insulin after meals or food ingestion, to help reduce high blood sugar. People with type 1 diabetes do not produce any pramlintide.<\/p>\n<p style=\"text-align: justify;\">According to the <a href=\"http:\/\/www.fda.gov\/\" target=\"_blank\">FDA<\/a>, which approved Symlin for use in treating type 1 diabetes in 2005, \u201cSymlim is an injectable medicine for adults with type 2 and type 1 diabetes to control blood sugar. Symlin slows down the movement of food through your stomach. This affects how fast sugar enters your blood after eating. Symlin is always used with insulin to help lower blood sugar during the 3 hours after meals.\u201d<\/p>\n<p style=\"text-align: justify;\"><a href=\"https:\/\/asweetlife.org\/wp-content\/uploads\/2014\/02\/Symlin-.jpg\" rel=\"mfp\"><img decoding=\"async\" class=\"alignleft size-full wp-image-35379 lazyload\" title=\"Symlin\" src=\"data:image\/gif;base64,R0lGODlhAQABAAAAACH5BAEKAAEALAAAAAABAAEAAAICTAEAOw==\" data-src=\"https:\/\/asweetlife.org\/wp-content\/uploads\/2014\/02\/Symlin-.jpg\" alt=\"Symlin\" width=\"190\" height=\"195\" \/><\/a>Symlin\u2019s manufacturer, <a href=\"http:\/\/www.bms.com\/ourcompany\/our_operations\/Pages\/amylin.aspx\" target=\"_blank\">Amylin Pharmaceuticals, Inc.<\/a>, says that Symlin works to reduce blood sugar by generating a feeling of fullness after meals, slowing the rate that the stomach empties after meals, and reduces the release of glucagon from the liver after meals. Symlin is recommended for type 1 diabetics who have not achieved good blood sugar control, which is decided on a case-by-cases basis by a person\u2019s physician.<\/p>\n<p style=\"text-align: justify;\">Some doctors are also prescribing metformin, which is the most prescribed oral type 2 diabetes treatment in the United States, off label as an adjunct to insulin for type 1 diabetics. \u201cSome of the more creative and aggressive endos are prescribing metformin for type 1&#8217;s, particularly if they are overweight or requiring very large basal insulin doses,\u201d according to <a href=\"https:\/\/asweetlife.org\/michael\/blogs\/insulin-pumps\/gary-scheiner-comes-through\/29855\/\" target=\"_blank\">Gary Scheiner<\/a>, a Certified Diabetes Educator. \u201cIn addition to having some mild appetite-suppression effects, it will enhance insulin sensitivity by hepatic cells (in the liver) and limit the amount of glucose secreted by the liver. Personally, I think it can be helpful during adolescence as well. As long as the patient has good liver and kidney function, the side effects and risks are negligible.\u201d<\/p>\n<p style=\"text-align: justify;\">Other drugs used to treat type 2 diabetics are being studied to see if they should be submitted to the FDA for approval to treat type 1 diabetics. These drugs, once-daily injectable <a href=\"https:\/\/asweetlife.org\/feature\/why-victoza-matters\/\" target=\"_blank\">Victoza<\/a>, Byetta, and once-weekly injectable Bydureon, are all GLP-1 agonists.<\/p>\n<p><img decoding=\"async\" class=\"aligncenter size-full wp-image-35378 lazyload\" title=\"VictozaPen\" src=\"data:image\/gif;base64,R0lGODlhAQABAAAAACH5BAEKAAEALAAAAAABAAEAAAICTAEAOw==\" data-src=\"https:\/\/asweetlife.org\/wp-content\/uploads\/2014\/02\/VictozaPen.jpg\" alt=\"Victoza Pen\" width=\"565\" height=\"165\" data-sizes=\"auto\" data-srcset=\"https:\/\/asweetlife.org\/wp-content\/uploads\/2014\/02\/VictozaPen.jpg 565w, https:\/\/asweetlife.org\/wp-content\/uploads\/2014\/02\/VictozaPen-300x88.jpg 300w\" sizes=\"(max-width: 565px) 100vw, 565px\" \/><\/p>\n<p style=\"text-align: justify;\">GLP-1 is a naturally occurring hormone released in the intestine that stimulates the release of insulin from pancreatic beta cells when carbohydrates are absorbed in the intestine. Additionally, GLP-1 (which stands for \u201cglucagon like peptide\u201d) is also present in the brain, where it acts as an appetite suppressant and produces one of the same effects of taking Symlin.<\/p>\n<p style=\"text-align: justify;\">Some limited research suggests that GLP-1 treatments might be effective in helping type 1 diabetics better control their blood sugar.<\/p>\n<p style=\"text-align: justify;\">\u201cSeveral small studies done on GLP-1 agonists for type 1 diabetes show encouraging potential for improving A1c and glycemic control, reducing insulin dose, reducing the risk of hypoglycemia, and helping with weight loss,\u201d the research website <a href=\"http:\/\/diatribe.us\/issues\/59\/conference-pearls\" target=\"_blank\">diaTribe reported in November 2013<\/a> as part of its of the coverage of the European Association for the Study of Diabetes conference.<\/p>\n<p style=\"text-align: justify;\">A full-scale clinical trial of Victoza on type 1 diabetics is potentially in the works from the maker of Victoza. Word of this comes after diaTribe\u2019s Editor-in-Chief, and type 1 diabetic, Kelly Close <a href=\"http:\/\/diatribe.org\/issues\/27\/test-drive\" target=\"_blank\">wrote about her positive experience taking Victoza for a \u201ctest drive.\u201d<\/a><\/p>\n<p style=\"text-align: justify;\">\u201cI realize, in my case with Victoza, that I am a sample of only one, but in that one, Victoza not only improved my glucose control but also bolstered my faith in the continued progress of diabetic therapies,\u201d Close wrote 2010. \u201cAll type 1 patients should have that opportunity. I urge Novo Nordisk to make the commitment, make the investment, and make it happen.\u201d<\/p>\n<p style=\"text-align: justify;\">After that article, Novo Nordisk responded to Close by indicating it was considering sponsoring a wide-scale study: \u201cYour personal experience provides one of many reasons why Novo Nordisk is currently considering exploring the use of Victoza for type 1 diabetes in well-designed, controlled, randomized clinical trials.\u00a0 While we can not guarantee the time course or the outcome, we are carefully evaluating the possibilities for launching such a program.\u201d<\/p>\n<p style=\"text-align: justify;\">Then, this January Novo Nordisk started recruiting more than 1,400 subjects <a href=\"http:\/\/clinicaltrials.gov\/ct2\/show\/NCT01836523?term=NCT01836523&amp;rank=1\" target=\"_blank\">for a 52-week trial on the effects of Victoza on type 1 diabetics<\/a>.<\/p>\n<p style=\"text-align: justify;\">Until that trial is completed and the FDA acts, however, Byetta, Victoza, and Bydureon are explicitly not approved for use by type 1 diabetics, according to the product warnings on each drug.<\/p>\n<p style=\"text-align: justify;\">If any type 1 diabetic wishes to try the drugs off label (which is the medical jargon for when patients receive a prescription to use a drug for a purpose for which it has not been FDA approved) researchers and doctors suggest consulting with a qualified endocrinologist experienced both in prescribing GLP-1 drugs and treating type 1 diabetics.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>The change in thinking about the ways type 2 diabetes evolves indirectly opened the door to considering new ways of thinking about how type 1 diabetes behaves. That shift led to considering whether that door swung both ways and if type 1 diabetics might benefit from treatments designed to treat type 2 diabetes.<\/p>\n","protected":false},"author":4,"featured_media":35377,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"image","meta":{"_relevanssi_hide_post":"","_relevanssi_hide_content":"","_relevanssi_pin_for_all":"","_relevanssi_pin_keywords":"","_relevanssi_unpin_keywords":"","_relevanssi_related_keywords":"","_relevanssi_related_include_ids":"","_relevanssi_related_exclude_ids":"","_relevanssi_related_no_append":"","_relevanssi_related_not_related":"","_relevanssi_related_posts":"","_relevanssi_noindex_reason":"","footnotes":""},"categories":[1443,1442],"tags":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO Premium plugin v22.9 (Yoast SEO v22.9) - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>Type 2 Diabetes Treatments May Benefit People with Type 1 Diabetes<\/title>\n<meta name=\"description\" content=\"Recent breakthroughs in type 2 diabetes treatments promise new treatment options for type 1 diabetics. 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