Is There a Vaccine for Type 1 Diabetes?

What the Ongoing Research Says

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People are being diagnosed with type 1 diabetes at an increasing rate, making the hope for a cure even more pressing. Research has been looking into how vaccines can play a role in preventing type 1 diabetes.

According to the Center for Disease Control’s 2020 National Statistics Report, type 1 diabetes diagnoses included 1.4 million adults, 20 years and older, and 187,000 children younger than 20.

These numbers total nearly 1.6 million Americans (roughly 1% of the population), an increase from the 1.25 million Americans with the condition in 2017. The CDC report also showed that diagnoses occurred most frequently between the ages of 5 and 14; 33.5% were aged 10-14, and 27% were aged 5-9.

Being that type 1 diabetes occurs more commonly in young kids, it is a disease that requires family involvement and parental management. Whether you have diabetes, love someone who does, or care for someone with diabetes, you know that developing a cure or a way to prevent his disease would be life-altering.

What Is Type 1 Diabetes?

Type 1 diabetes is an autoimmune disease than affects the beta cells of the pancreas that make insulin. Insulin is a hormone that has many functions, one of the most important of which is bringing glucose from the blood to the cells to use for energy.

People who develop type 1 diabetes need to take insulin in the form of injection or infusion to manage blood sugar. Type 1 diabetes management takes hard work and diligence.

In addition to medication management, people with type 1 diabetes must test their blood sugars multiple times a day, count carbohydrates to match insulin doses, and control blood glucose highs and lows by pattern managing.

Type 1 diabetes cannot be prevented or cured (yet). And while advancements in technology have made type 1 diabetes easier to manage, scientists have long been studying the probability of developing a vaccine to prevent type 1 diabetes.

What Causes Type 1 Diabetes

Developing a vaccine is complicated because there are still so many unknowns about what triggers the development of type 1diabetes. Certain genes, antibodies, and proteins can increase the likelihood of developing diabetes as well environmental triggers.

According to the American Diabetes Association, most White people with type 1 diabetes have genes called HLA-DR3 or HLA-DR4, which are linked to autoimmune disease. Suspect genes in other ethnic groups may put people at increased risk.

For example, scientists believe that HLA-DR9 gene may put Blacks at risk and HLA-DR9 gene may put Japanese people at risk. We do know that diet and lifestyle habits do not cause type 1 diabetes.

Dr. Utpal Pajvani, physician scientist and endocrinologist at the Naomi Berrie Diabetes Center at Columbia University says, “One clear risk factor for type 1 diabetes is genetics. If your parent has diabetes, you are at 3 to 5 times more likely to develop it. And if you have an identical twin sibling that has type 1 diabetes, odds are you will get it, it’s just a matter of when.”

"For example, rotavirus, a common gastrointestinal virus known to cause diarrhea, has been linked with type 1 diabetes. When pediatricians started to vaccinate for this virus, we saw that the rate of diabetes diagnoses went down," says Pajvani.

In fact, in a scientific report published in Nature, researchers discovered that there was a 3.4% decrease in the incidence of diabetes annually in children ages 0–4 in the United States from 2006–2017 which coincides with the vaccine introduction in 2006.

They concluded that the rotavirus vaccination is associated with a reduced incidence of type 1 diabetes. This is great news; however, the problem is that this is not the only virus associated with type 1 diabetes.

Pajvani says, “The problem is that there are likely multiple viruses that may trigger type 1 diabetes in a person who is genetically primed for it. Beyond this unknown, we don’t know all the genetic susceptibilities.”

Research in Vaccine Development

Vaccine development takes on a wide range of hypotheses. Dr. Pajvani tells Verywell, “There are multiple potential approaches to develop a vaccine for diabetes. Some studies focus on giving oral insulin, while others are using plasmids (pieces of DNA) to make insulin. The goal is to teach the immune system not to attack itself.”

Other types of research focus on preventing immune responses to certain viruses that may increase the likelihood of developing type 1 diabetes.

Focusing on the Insulin Making Beta Cells

To date research for a vaccine has taken place in preventing diabetes in people who are predisposed, as well as in people with living with type 1 diabetes. Some clinical trials have been done on animals, while very few have been done in humans.

There are many variables that can affect blood sugar, including hormones, stress, illness, food, exercise. In addition to the vigorous management of type 1 diabetes, it is also expensive, especially today with insulin costs increasing.

In a study published in The Lancet, researchers tested the safety and feasibility data of a first-in-man-prospective open-labeled, placebo-controlled, dose-escalation phase 1 trial in nine people with long-standing type 1 diabetes (for at least 12 years).

The researchers aimed at investigating the use of tolerogenic dendritic cells (TolDCs) and proinsulin peptide (the precursor to insulin) to intervene in the pathogenesis of type 1 diabetes. Tolerogenic dendritic cells are a type of immune responding cell that may be able to manage the beginning of underlying autoimmunity at the time-at-onset and onwards.

Participants were administered two intradermal vaccinations series (5, 10, or 20, depending on dose cohort) of TolDCs pulsed with proinsulin peptide, one month apart. During the six months of intensive monitoring, the researchers found that all participants diabetes control remained stable and that the intervention appeared to be safe and well-tolerated, with few adverse reactions.

Although they did not “cure” the participants of diabetes, there was no acceleration of beta cell loss during the intervention. They concluded that their study warrants “Subsequent clinical testing in patients with a shorter diagnosis of type 1 diabetes (less than 12 years) and with preserved C-peptide production, to assess whether this novel immune intervention strategy is able to delay or halt progressive loss of beta cell function.”

Focusing on Disease Prevention

Another study to recently hit the news approaches a vaccine for type 1 diabetes in an alternative way. As mentioned, it has been discovered that certain viruses are linked to the development of type 1 diabetes, one speculated culprit, Coxsackievirus B (CVB) enteroviruses. There are six different strains of this virus, all of which are linked to different diseases.

Researchers formulated a vaccine for all six strains of CVB and found that it had positive results on both mice and monkeys. When given to monkeys, the vaccine stimulated antibodies to CVB, which implied that if it could prevent the development of CVB then it could prevent diabetes.

While this research is certainly promising, there are a few drawbacks to the study. First off, the study was done in animals which has its own limitations.

In addition, it is difficult to determine if children who are predisposed to type 1 diabetes will develop the disease after exposure to a different type of virus or infection. More research will be needed to determine if these vaccines are safe and applicable in children.

The good news is that if they are, there is a chance they can prevent the cases of diabetes in children that are potentially caused by CVB.

What Do the Experts Say?

“We know that viral infections can unmask type 1 diabetes,” says Dr. Pajvani. “As a proponent of vaccines, I think following through with recommended vaccinations to prevent infectious diseases is the correct approach. And if you are at genetic risk of type 1 diabetes, there may be an additional benefit to delay diabetes if the epidemiologic studies prove true. But I am doubtful that targeting infection by individual viruses will prevent or cure diabetes."

Dr. Pajvani says, “An effective vaccine for diabetes is more likely to be 'on target,' using a plasmid that prevents your immune system from attacking your beta cells.”

Organizations are Working Hard for a Cure

Even though there is no vaccine or a proven cure for type 1 diabetes, it does not mean that organizations and scientists will stop looking for one. In fact, the Juvenile Diabetes Research Foundation (a not-for-profit organization) is committed to finding a cure and helping people with diabetes live a full and healthy life.

The mystery of type 1 diabetes is what environmental triggers can prompt overt disease. Dr. Pajvani tells Verywell, “Newer research on vaccine development is complicated. There have been several viruses thought to trigger type 1 diabetes."

Their mission is to accelerate life-changing breakthroughs to cure, prevent, and treat type 1 diabetes and its complications. Their current research efforts focus on a plethora of important research developments, including artificial pancreas, childhood vaccine, beta cell therapies (including preserving beta cell function), and immunotherapies, to name a few.

If you are not familiar with the JDRF, you would benefit from learning more about them.

At-Risk Screening

If you have type 1 diabetes and have children, it does not mean that they will automatically get diabetes. However, when compared to children born to parents without diabetes, they are at increased risk.

If you suspect that you or your child are at increased risk of developing type 1 diabetes you might be eligible for a risk screening offered through TrialNet Pathway to Prevention Study. This risk screening is free to relatives of people with type 1 diabetes and uses a blood test to detect risk before symptoms appear.

People who are found to be in the early stages of developing type 1 diabetes may also be eligible for the prevention study.

A Word From Verywell

Type 1 diabetes is a disease that needs to be managed daily. But, living well with type 1 diabetes is possible, especially with advancements in technology, access to education, and care.

Although there is currently no way to prevent or cure type 1 diabetes, scientists, physicians, organizations, and type 1 diabetes advocates are working hard to get there. We can expect to continue to see emerging news about vaccines targeting viruses and immune responses at the forefront of research.

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  2. American Diabetes Association. Learn the genetics of diabetes.

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