By Adriana Carrillo Iregui, MD
Medical Director of the Diabetes Program
About Dr. Carrillo
Type 1 diabetes (T1D) continues to be a prevalent and growing concern among children in the United States. According to the Juvenile Diabetes Research Foundation (JDRF), 1.45 million Americans have T1D, but that number is expected to grow to 2.1 million by 2040. Between the years 2001 and 2009, the number of individuals with T1D under the age of 20 rose by 21 percent.
What’s more, the COVID-19 pandemic raised even greater concerns for children with T1D and their families. The CDC says that children with diabetes face a greater risk of severe symptoms from COVID-19 infection. In addition, two publications in 2022 , a review article published in the Annals of Pediatric Endocrinology & Metabolism noted that children who have been infected by COVID-19 may have a greater risk of pancreatic injury and developing diabetes and a study published in JAMA indicated greater risk for developing T1 within 6 months after COVID infection.
Fortunately, there is hopeful news when it comes to T1D. There are numerous new medical developments to support treatment. Many of these offerings are available through the Nicklaus Children’s diabetes program.
Delaying Diabetes Onset
One of the most exciting recent T1D developments is a medication known as teplizumab, which is an antibody that binds to T cells to reduce immune response. According to the National Institutes of Health (NIH), a 2019 study showed that a two-week regimen of the medication reduced the onset of T1D in patients by two years, and also cut in half the overall rate of diabetes diagnoses. Individuals in the study who took the medication developed diabetes on average 60 months after treatment, compared to 27 months for those who did not take the medication. Also, 50 percent of those treated remained diabetes-free through the follow-up period, compared to 22 percent of those not treated.
Better Insulin Management
Insulin management to control T1D symptoms has always been a challenge, particularly in very young children. But a new tubeless closed-loop system, known as Omnipod 5 (Insulet), has shown promise in a study of 80 children ages 2 to 6 years old. Children in the study who used this system showed a significant improvement in blood sugar control, as well as in other factors relevant in T1D.
Helping with Weight Loss
One major lifestyle factor in managing the symptoms of T1D is keeping weight at a healthy level. The FDA recently approved a drug known as Qsymia that can help with that effort. This medication has been in use in adults since 2012, but it was recently approved to help manage obesity in children ages 12 and older. In a recent 56-week study of the drug with 223 participants ages 12 to 17, those who took Qsymia lost on average 4.8 to 7.1 percent of their BMI during the study, depending on the strength of the medication dosage. Those in the placebo group gained weight over the course of the study.
Pathway to Prevention
One final bit of good news related to T1D is the ongoing Pathway to Prevention study, a trial in which Nicklaus Children’s Hospital is actively participating. As part of this study, family members of children with T1D are encouraged to be screened (at no cost) to determine their risk of developing T1D themselves.
This is an important screening, as relatives of those with T1D have a 15 times greater risk of developing the disease than the general population. After the initial screening, regular monitoring can improve outcomes and prevent complications for those at risk of T1D. If you have a family member with T1D, I encourage you to schedule your screening with us as soon as possible.