GAD Treatment and Insulin Secretion in Recent-Onset Type 1 Diabetes

This study aimed to test whether injections of alum-formulated glutamic acid decarboxylase 65 (GAD), a major autoantigen in type 1 diabetes mellitus, would reverse recent-onset disease. C-peptide levels declined in both the treatment group and the control group, without significant between-group differences at month 15 (the primary end point), but they had declined significantly more slowly with treatment by month 30. The authors conclude that alum-formulated GAD may help preserve residual insulin secretion in patients with recent-onset type 1 diabetes. Study patients received injections of alum-formulated glutamic acid decarboxylase 65 (GAD). C-peptide levels declined in both the treatment group and the control group, but they had declined significantly more slowly with treatment by month 30. Type 1 diabetes mellitus is an autoimmune disease 1 that causes substantial morbidity and mortality. 2 , 3 Even modest residual insulin secretion, with stimulated C-peptide levels above 0.2 nmol per liter (0.6 ng per milliliter), has been reported to provide clinically meaningful benefits in terms of reducing long-term complications. 4 However, most attempts to preserve residual beta-cell function have achieved minimal benefits or have been associated with adverse effects. 5 – 14 Treatment with anti-CD3 monoclonal antibodies appears promising, although many patients in whom this approach has been used have had therapy-related adverse events. 15 , 16 As an alternative to immunosuppression, autoantigens may be used to . . .