A major large-scale trial in Scotland aims to prevent the development of type 1 diabetes in children. Researchers will begin reaching out to approximately 6,400 Scottish families living with type 1 diabetes.

Specifically, children who have either a parent or a sibling diagnosed with the disease will be given a blood test to analyze their risk level in developing the condition.

The child participants with high risks will be given metformin, a drug commonly prescribed for type 2 diabetes patients. The goal is to determine if the same drug can prevent the disease development.

Findings from this major trial called the autoimmune diabetes Accelerator Prevention Trial (adAPT), can dispute the long-standing notions about the causes of type 1 diabetes.

Previous studies hypothesized that the disease is caused by a defective immune system that destroys the pancreas' beta cells that produce insulin. Past trials used drugs to halt the immune system's attack, however, the trials did not have promising results.

The new trial will test another theory proposed by University of Exeter Medical School's Professor Terence Wilkin in 2001. This alternative theory believes that the immune system can be made to protect the beta cells instead.

"However, if the rate of beta cell loss is accelerated, type 1 diabetes develops, and the faster the loss, the younger the onset of the condition," said Wilkin.

In the trial's first stage, a child participant will be given either metformin or a placebo for four months. Within this timeframe, participants will undergo three tests to analyze the response of their immune system and metabolism to the drug or placebo.

This stage will test the efficacy and gauge the safety of the trial design. If metformin proves effective in reducing the stress levels of beta cells, the successful participants will go on to the trial's succeeding stages.

Wilkin, together with University of Dundee's Professor Stephen Greene and the Tayside Clinical Trials Unit, is conducting this major trial in Scotland, where type 1 diabetes rate among children is third highest globally.

Photo: Valters Krontals | Flickr

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