Diabetes Mellitus, Type 1 Clinical Trial
Official title:
Efficacy of 6 Months Treatment With Diazoxide at Bedtime in Preventing Beta-cell Demise in Newly Diagnosed Type 1 Diabetes
The purpose of this study is to find out if Diazoxide can partly retain insulin production in newly diagnosed type 1 diabetes patients.
At the time of diagnosis most subjects with type 1 diabetes retain significant endogenous
insulin secretion as assessed by C-peptide measurements. Although not sufficient for the
needs of the individual, residual insulin secretion is important for metabolic control, for
avoidance of hypoglycemic episodes and, perhaps, for protection against diabetic
complications. To retain residual endogenous insulin secretion in type 1 diabetes is thus
highly desirable.
Residual insulin secretion deteriorates during the course of type 1 diabetes. The underlying
autoimmune process is a major determinant of deterioration.
However, also measures that do not directly target the immune system could be beneficial.
The DCCT study randomised subjects with type 1 diabetes to either intensive or conventional
insulin treatment. The intensive insulin treatment markedly retarded deterioration in
C-peptide levels during 5 years of observation. The favourable effect could be due to lesser
hyperglycemia per se. Alternatively, the effect of intensive insulin treatment could be
secondary to lesser degree of over-stimulation of the patients' beta-cells.
It is by now established that relief from over-stimulation by diazoxide favourably affects
beta-cell function and that such treatment can retard a decline in residual insulin
secretion in subjects with newly diagnosed type 1 diabetes. Diazoxide has been used in
clinical practice for > three decades without major safety concerns.
Disturbing, albeit reversible, side effects are halting long-term studies with diazoxide in
type 1 diabetes. The researchers find that lower and intermittent (i.e. night time) dosing
of diazoxide produces no measurable side effects in subjects with type 2 diabetes.
This is a double blinded placebo controlled study, with 35 participants with newly diagnosed
type 1 diabetes are randomised into either placebo or Diazoxide for 6 months. The patients
will be followed up after intervention for at least 12 months.
Beta cell function and glycemic control will be monitored.
;
Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Double Blind (Subject, Caregiver, Investigator), Primary Purpose: Treatment
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