Does blocking glucagon cure type 1 diabetes?

[Bubbleblower]

<edit moderator> The short answer is no, but this makes an interesting read. </edit>

Google translated from this page from 2020 about the biomarker study:
https://diabeter.nl/nl/over-diabeter/nieuws/update-biomarkeronderzoek/

We soon want to investigate the role of the hormone glucagon in type 1 diabetes. Glucagon (from the orange emergency box and recently also available in a nasal spray) is made just like insulin by the islets of Langerhans, but in the alpha cells. While insulin lowers the glucose in your blood, glucagon increases it. In type 1 diabetes Insulin production becomes defective, but glucagon production does not immediately. On the contrary, what we see is that some people with type 1 diabetes actually make too much glucagon, which causes the glucose to rise further. Some people also make much more after meals glucagon and that increases the glucose even more. We will investigate whether we can see in which people glucagon has a disruptive effect and whether we can do something about it, for example with glucagon-regulating medicines.

The outcomes from this study* are very interesting for type 1’s that produce too much glucagon.

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If I google what percentage type 1's does produce too much glucagon the first hit I got is this:
https://discovery.med.utah.edu/2021/glucagon-be-gone-a-cure-for-type-1-diabetes/

University of Utah Health investigator William Holland, PhD, and colleagues found that blocking glucagon action in mice restored levels of both insulin and glucose, effectively curing type 1 diabetes. Their groundbreaking work, which was published in the Proceedings of the National Academy of Sciences, reveals that suppressing glucagon production or action may be a viable means of treating type 1 diabetes.

They refer to: Glucagon blockade restores functional β-cell mass in type 1 diabetic mice and enhances function of human islets but this is already studied in humans too and the outcomes are discussed in this webinar: differences between type 1 diabetes (in Dutch).

* @57:53 The lead scientist of this human study says; if you give a type 2 drug like GLP-1 (to type 1’s) it turns out you can get beta cells working again. Both in mice and humans.

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The answer to the clickbait question is no unfortunately, this doesn’t cure diabetes, but it does prevent hypo’s and hypers, improves QOL drastically and I assume reduces the risk for all kinds of complications like atherosclerosis and dementia, which I fear the most.

 

[rebrascora]

If this were to work in humans, I am not sure I would prefer to take a GLP-1 over insulin or whether it would be cheaper ie cost effective to do so and would it be a cure or just a different way to treat Type 1? ie would you be on a GLP-1 for life instead of insulin or are you saying it is a one off treatment option and if so, how do you stop further autoimmune destruction of beta cells? And what about the weight loss associated with GLP-1s. There are plenty of Type 1s who cannot afford to lose any weight?
And that is without considering the current shortage of GLP-1 medications.....

Just some of my thoughts or am I misunderstanding something?

 

[Bubbleblower]

am I misunderstanding something?

Unfortunately I am not good at explaining these things clearly enough;
Blocking glucagon restores beta cell function <mod edit> in mice </edit>, even if there is still an auto immune attack.
This has also been tested in humans and it worked.

how do you stop further autoimmune destruction of beta cells? And what about the weight loss associated with GLP-1s. There are plenty of Type 1s who cannot afford to lose any weight?

The case in Amsterdam that increased C-peptide from 250 pmol/l to 500 pmol/l in 35 months had that problem too, which he solved by eating as much as he can. That case had high GAD antibodies as well, but apparently you can make new beta cells faster than antibodies destroy them, which was already found in the study above as well.
He didn't use any GLP-1 medications, you don't necessarily need those to increase GLP-1.

That 500 pmol/l is much higher than that of all 611 participants of the biomarker study or the 489 participants in the GUTDM1 cohort, so that really is significant as is the fact the C-peptide clearly went up instead of down.

<edit moderator> The short answer is no, but this makes an interesting read. </edit>

It is important to realise why that answer is no; beta cell loss is a consequence of diabetes, not a cause.

It is still good news that in most cases (may be all?) you can reverse it, which has many benefits, the Diabeter page mentions; easier glycemic control, less hypo’s, less complications, better hypo awareness and better quality of life.
It ends the rollercoaster you are in with conventional treatment, your CV, coefficient of variation, may go down from typically above 40% to around 10%, you get C instead of B or in many cases A:



Hopefully I explained it better this time, this is a big deal.

 

[everydayupsanddowns]

This thread is being locked because it is making claims about results from the Diabeter centre in the Netherlands, which cannot be verified. No published trial data or studies from Diabeter can be found which back up the claims being made about human trials. Results that have been found largely involve promising results with mice.

It is important for newly diagnosed T1s to understand that the techniques being discussed here are based on experimental techniques which may prove helpful in 5-10 years.

This 2013 paper summarises work into blocking Glucagon and attempting to increase beta cell mass in both T1D and T2D

β-cell preservation and regeneration for diabetes treatment: where are we now? - PMC

Over the last decade, our knowledge of β-cell biology has expanded with the use of new scientific techniques and strategies. Growth factors, hormones and small molecules have been shown to enhance β-cell proliferation and function. Stem cell ...

pmc.ncbi.nlm.nih.gov

This 2021 human trial into a glucagon receptor antagonist found modest HbA1c and glycaemic improvements in people with T1D

https://diabetesjournals.org/diabetes/article/70/Supplement_1/236-OR/139879/236-OR-Volagidemab-a-Human-Glucagon-Receptor

Improved management of T1 is possible, through a number of means both pharmacological and technological, but the current state of knowledge is that T1 Diabetes (absolute insulin deficiency from auto-immune attack on beta cells in the pancreas) cannot be reversed. There is currently no cure for T1 Diabetes.