Around 400,000 people in Germany live with type 1 diabetes. At the Heart and Diabetes Center NRW (HDZ NRW), Bad Oeynhausen, a new drug is now available, which was approved by the European Union at the beginning of the year. Studies show that the active ingredient teplizumab can delay the onset of disease symptoms by up to two years on average. Under the name TzieldTM, the preparation has already been in use in the USA for several years.

Prof. Dr. Susanne Reger-Tan, Director of the Clinic for Diabetology and Endocrinology at the HDZ NRW, explains the mode of action of the new drug:

Reger-Tan: Type 1 diabetes is an autoimmune disease in which the immune system attacks and destroys the insulin-producing beta cells in the pancreas. We distinguish between three stages of the disease: the precursors (stages 1 and 2) and stage 3, which is characterized by clear clinical symptoms. The antibody teplizumab can slow down the autoimmune process in stage 2 patients. This means that for the first time in Germany, we now have an immunomodulatory therapy for type 1 diabetes at our disposal.

How can you determine whether the therapy is an option?

Reger-Tan: This is currently only possible on the basis of blood tests. Stage 2 is characterized by certain antibodies and impaired glucose metabolism with slightly elevated glucose levels. Such changes can be detected as part of a special examination. Relatives of people with type 1 diabetes, for example, are recommended such an examination. If there is a suspicion, our clinic under the senior medical direction of Dr. Young-Hee Lee-Barkey also offers screening for adolescents and adults.

Who should be examined?

Reger-Tan: Anyone who has close relatives – i.e. parents, siblings or children – with type 1 diabetes in the family should be particularly attentive. For first-degree relatives, the risk of disease is about five to ten percent. If both parents are affected, the risk for children can increase to up to 25 percent, according to individual studies even to up to 40 percent. It can take a few years before significant symptoms such as severe thirst, frequent urination or weight loss appear. Teplizumab can help to delay this point in time and thus possibly have a positive influence on the course of the disease.

What challenges does the new therapy entail?

Reger-Tan: Comprehensive screening would make sense in principle, as around 90 percent of those affected do not have relatives with a first-degree condition. Corresponding programs are currently being discussed in the professional societies, especially for newborns.

In addition, there is the high cost of production and treatment. The drug is administered by infusion over a period of 14 days. For this reason, teplizumab is currently only used at specialized centers in Germany.

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Editor: X-Press Journalistenbüro GbR

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