An endocrinologist at the Royal Melbourne Hospital (RMH) is leading an Australian-first trial that looks at whether an insulin nasal spray, coupled with an injection, is effective in slowing down the immune attack that causes type 1 diabetes.

The IAA or ‘Abatacept combined with nasal insulin in recently-diagnosed type 1 diabetes’ trial, being led by the Australasian Type 1 Diabetes Collaborative (ATIC), is now recruiting participants to their trial sites in Melbourne, Perth, Adelaide, Brisbane and Sydney.

The RMH endocrinologist Associate Professor John Wentworth is lead investigator for ATIC and the primary investigator in the research that led to the IAA study. John and his team were able to identify two different therapies that interact with the body’s immune system in different ways. If this dual intervention approach proves effective, it could delay the need for insulin injections.

“It’s tremendously exciting to see this particular trial come to fruition in Australia,” John said.

“Combination immunotherapy trials are not all that common; the IAA trial is one of just a few that are on offer globally.”

Doctor checking child's blood sugar

The two specific therapies John and his team and looking at in this trial is the combination of Abatacept and nasal insulin.

Abatacept is a drug that is currently used to treat other autoimmune diseases, like rheumatoid arthritis. It is known as a modified antibody, and its key role in the trial is to interfere with a type of immune cell called T cells, to disrupt the body’s immune response. Given as an injection under the skin, previous trials have shown it to be safe and effective in maintaining pancreas function shortly after type 1 diagnosis.

Nasal insulin, unlike injected insulin, does not affect blood sugar levels. When given through the nose, it teaches the immune system in the nasal passageways to generate immune cells whose job it is to regulate the immune response. These cells then travel to the pancreas to help turn off the immune attack that causes type 1 diabetes.

Trial participants will receive abatacept in combination with either nasal insulin or placebo over a 48-week period. They will be required to attend their local trial centre 16 times over two years, with most visits lasting less than one hour.

“ATIC was set up as a result of the advocacy of the type 1 community in Australia,” said John.

“We’re hoping they are able to help us spread the word to help us make this trial a success, and to help decrease the burden of living with type 1 diabetes for those diagnosed in the future.”

Individuals aged 6 to 21, who are within 100 days of their type 1 diabetes diagnosis can apply for the IAA trial.

For more information or to apply, please visit the ATIC website.

Mobile Stroke Unit with Ambulance Victoria paramedic and the RMH Stroke team
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