Skip to Main Content

Spotlight on Clinical Research: Diabetes

Studies Seek Ways to Prevent and Improve Treatment for Diabetes
Kevan Herold, MD
Kevan Herold, MD, Professor of Immunobiology and of Medicine (Endocrinology); Deputy Director for Translational Science, YCCI
Yale researchers developed the insulin pump to treat Type 1 diabetes in 1979. Today, it’s used by more than 350,000 patients. Our tradition of discovery continues today with studies on ways to prevent Type 1 diabetes and develop better treatments for Type 2 diabetes.

Type 1 Diabetes

Relatives of people with Type 1 diabetes have a 10 to 15 times greater risk for developing the disease than people with no family history. TrialNet is a series of studies designed to delay or prevent Type 1 diabetes in people at risk for developing the disease. The screening study involves a blood test for diabetes-related autoantibodies that indicate an increased risk of developing diabetes. These autoantibodies can sometimes be found in the blood years before Type 1 diabetes occurs.

Family members who test positive may be eligible to participate in one of TrialNet’s three prevention studies. These studies are designed to test medications to prevent Type 1 diabetes. One study involves anti-CD3, an antibody Dr. Kevan Herold helped develop that quiets the T cells responsible for destroying insulin-producing beta cells in the pancreas. Another study involves abatacept, a drug used to treat other autoimmune diseases that has also shown promise in preserving insulin production in people newly diagnosed with Type 1 diabetes. The third study involves oral insulin, which may help prevent diabetes in those with higher levels of insulin autoantibodies, which are directed against insulin itself.

If you have Type 1 diabetes, now is a good time to have your family members screened to see whether they might qualify for studies to try to prevent the disease. For more information, contact Laurie Feldman at 203-737-2760 or laurie.feldman.yale.edu.

Type 2 Diabetes

Type 2 diabetes is the most common form of diabetes. It affects more than 15 million Americans. Therapy for this disease has been around for almost 60 years, yet doctors still can’t agree on the best treatment strategy after metformin, widely viewed as the best pill to use in newly diagnosed patients. Unfortunately, many patients will need another medication in addition to metformin to get their blood sugar levels down to their goal. 

There are plenty of options, each with its own unique way to reduce blood sugar and its own additional benefits, but also certain side effects. There is a lot of debate about which drug is best, with strong arguments on either side. Unfortunately, we don’t know enough about how effective each of these medicines will be in controlling blood sugar levels in the long run, so the National Institutes of Health has called upon researchers to design a study to answer this question. 

This study, known as GRADE, is being conducted in 37 sites around the country. Four medicines will be compared in patients who are not achieving adequate control with metformin alone.  The researchers hope to answer the important question of which medicine has a better effect on diabetes in the long term and which is tolerated better by patients. If you or someone you know is interested in finding out more about GRADE, please contact Patty Gatcomb, APRN at 203-764-8463 or patricia.gatcomb@yale.edu or Michele Alguard at 203-764-6649 or michele.alguard@yale.edu.