Doing away with the diabetes needle

Doctors have developed a concoction of two drugs that can reverse diabetes.

Scientists have described the discovery as "an important step towards a potential cure".

It could mean an end to the daily insulin injections and rigid dietary restrictions suffered by millions world-wide.

Diabetes New Zealand said the drug mixture was great news for sufferers of Type 1 diabetes.

"We'd like to see more clinical trials to ensure that it's safe but we applaud the direction it's taking," said president Murray Dear.

Currently the only option for people with Type 1 diabetes other than taking insulin was to have a pancreatic transplant, which required a lifetime of immunosuppressant drugs.

"It's not really what you'd call a cure," he said.

The drugs cocktail, developed in California, has so far been tested on animals but each of its constituents is already being tested individually in human clinical trials.

The treatment is for Type 1 diabetes, which usually starts in childhood. Type 1 diabetes occurs when the body's immune system, instead of fending off infection, turns on itself and attacks the insulin-producing cells of the pancreas.

The new drugs blend, developed by scientists at La Jolla Institute for Allergy and Immunology, San Diego, combines a monoclonal antibody which calms the immune system with a peptide that acts like a vaccine to protect the insulin-producing cells.

In laboratory mice given the cocktail, it was more effective, had longer lasting results and fewer side effects than either therapy had shown alone in the human studies. In most of the animals tested diabetes was reversed.

Trials of the monoclonal antibody in humans have already shown it can reverse Type 1 diabetes but although the effect lasted for more than a year, the diabetes then returned.

The results of the new study suggest that when combined with the peptide, the two drugs act synergistically to produce a greater effect than either has individually.

The research team, led by Matthias von Herrath, said it hoped to begin human trials of the combination therapy later this year but was waiting for approval from drug safety regulators.

The antibody is taken orally and the peptide by nasal spray, avoiding the need for injections. The approach focuses on teaching the immune system to tolerate, not attack, insulin-producing cells of the pancreas.

The danger of suppressing the immune system is that it puts patients at increased risk of cancers or viral infections. But by combining drugs, a lower dose of the immuno-suppressant antibody is required with a lower risk of side effects.

Diabetics inject insulin to control their blood sugar levels but complete control is difficult to achieve. Complications can lead to kidney failure, blindness and amputations.

Mitchell Kronenberg, president and scientific director of La Jolla, said: "If successful in humans, this could replace injection treatments altogether, which often cannot prevent the long-term detrimental effects of diabetes."

- INDEPENDENT, additional reporting by Juliet Rowan