Psoriasis drug shows promise for treating type 1 diabetes

New research finds that ustekinumab, a drug commonly used to treat psoriasis, may help children and adolescents with type 1 diabetes keep making insulin for longer. 

Results from a clinical trial named USTEKID, published in the journal Nature Medicine, suggest that ustekinumab may be effective in treating the early stages of type 1 diabetes in children and adolescents.

Protecting insulin-making cells 

Co-funded by our JDRF affiliate in the UK, the study demonstrated that ustekinumab is effective in preserving the body’s ability to produce insulin in type 1 diabetes, bringing the goal of managing type 1 diabetes without insulin a step closer. After 12 months, the participants who were taking ustekinumab had C-peptide levels – a sign that the body is producing insulin – that were 49% higher than the group who were taking a placebo. 

The study showed that ustekinumab reduced the destructive impact of specific immune cells on insulin-making beta cells. The drug treats the underlying immune process that causes type 1 diabetes, making it different from insulin injections that top up the lack of insulin for people with type 1. 

Reducing the need for insulin 

Dr Danijela Tatovic, who led the research project, said: “Type 1 diabetes occurs when the body’s immune system attacks and destroys the cells of the body that produce insulin. This eventually leaves the person dependent on insulin injections. Researchers are now developing ways to slow or halt the immune system attack. If such treatments can be started early, before all the insulin-making cells are lost, this could prevent or reduce the need for insulin.” 

The USTEKID clinical trial 

Led by researchers at Cardiff University, the clinical trial tested ustekinumab in 72 young people between 12 and 18 years old who were within 100 days of being diagnosed with type 1 diabetes. At universities and hospitals across the UK, the teenagers were given injections of either ustekinumab or a placebo seven times over 44 weeks. The participants also gave blood and urine samples and completed three short questionnaires.  

In Canada, a JDRF-funded study is testing Ustekinumab in adults, within 100 days of being diagnosed with type 1. As the drug is already approved for use in Canada, if the trial results are positive, moving forward to clinical use would not only be feasible, but rapid. 

This phase II/III trial is taking place at BCDiabetes in Vancouver, under the leadership of Tom Elliott, MBBS, and the University of Toronto, under Bruce Perkins, M.D., MPH, both in Canada. There will be a total of 60 participants enrolled between the ages of 18-25 years old.  

A JDRF grant is also supporting Megan Levings, Ph.D. and her team, at the BC Children’s Hospital Research Institute, as they aim to harmonize the biomarkers of response in both the Canadian and UK clinical trials, increasing the sample size and more rapidly identifying whether this is an effective therapy for T1D.  

What is ustekinumab? 

Ustekinumab is an established immunotherapy, meaning it targets the immune cells in the body. It is used by Canadians living with immune conditions, including severe psoriasis, psoriatic arthritis, severe Crohn’s disease and severe ulcerative colitis. The drug is given as an injection, which people can give themselves at home.  

A precision medicine 

Dr. Megan Levings, who worked on a Canadian arm of the study, said: “We have been working on the idea that a drug like ustekinumab could be beneficial in type 1 diabetes for more than a decade so it is really exciting to see the results of this study. My team’s contribution was to set up blood tests to measure how ustekinumab affects the immune system. It turned out that the results of these tests were very important to identify which children responded the best to the drug. Personalized immunology in action!”  

Crucial JDRF UK funding 

The USTEKID trial provides the first clinical trial-based evidence for the role of this type of immune cell in type 1 diabetes. Identifying the specific immune cells that cause damage to the insulin-making beta cells could pave the way for precise and targeted therapies to maximise benefits and minimise side effects for people living with type 1. 

Professor Tim Tree, who led the research team at King’s College London, said: “JDRF UK funding was instrumental in the biomarker experiments in the project where we examined blood samples from the trial participants. This was the key to linking a reduction in these cells with a good outcome in those treated with the drug. This offers opportunities to personalise therapy to those most likely to benefit or test newer therapies that might target this population of cells more quickly and potently.” 

More research needed 

While the trial demonstrates the benefit of using ustekinumab to treat type 1 diabetes, further clinical trials are required to confirm this finding and to work out which patients would benefit most from the treatment. The researchers also hope to test whether this drug could be used to treat individuals at earlier stages of type 1, before they ever need insulin therapy. 

To learn more about how to be involved in the Ustekinumab clinical trials in Canada, please visit our Clinical Trials Finder tool.

Faces of the $100M Campaign to Accelerate: Bonnie’s Story

Bonnie with her husband, Brian

The $100M Campaign to Accelerate is JDRF’s bold fundraising plan to speed up research toward a world without T1D. Our campaign is divided into six key support pillars to help accelerate cures while improving lives. Thanks to devoted JDRF donors and volunteers like Bonnie, this major gift campaign has raised over $78M, funding more T1D research than ever before.

Bonnie’s son, Bryn, was diagnosed with T1D in 1990, shortly after his 5th birthday. There was no known diabetes in their family, and she didn’t know the early signs and symptoms. Bryn hadn’t been feeling well for quite a while and had very little energy. He loved running and playing with his friends at daycare, but Bonnie noticed he was having difficulty keeping up – it was then that she knew something was wrong.

After bringing Bryn to the doctor’s office, they had to go to the lab for a blood test. Bonnie says, “I was really freaked out for this poor little guy. I realized that we had to find out [whether he had T1D], but I just felt so bad for him and, as a mom, challenged to get him through a blood test.

The doctor called Bonnie to inform her that Bryn’s blood glucose levels were very high. She immediately had to pack an overnight bag and check Bryn into the hospital. At the time, children diagnosed with T1D were typically hospitalized for about one month. Bonnie didn’t want to leave young Bryn on his own, so every morning, she would gather her three other children and head straight to the hospital in pyjamas. Eventually, they all moved into Bryn’s hospital room, trying to make it a fun adventure for the kids. Using the hospital’s playroom and watching TV were little things that went a long way in helping their family get through a difficult time.

“The first little while was very rough,” Bonnie says. “I was just so overwhelmed that I couldn’t take it. I didn’t know how to survive because I thought, ‘This child is going to need all this special care and meals and so much.’ I was treading water as it was with four little ones, and it was a lot.”

Bonnie and her family went home after two weeks, feeling very proud of Bryn. Yet there would be many firsts to face as a mother of a child with T1D – like the first time Bonnie accidentally gave Bryn too much insulin. She panicked, thinking it was all over. Bonnie says there are many traumas she faced in the beginning, but their family slowly got used to life with T1D.

Bonnie’s daughter, Jillian, was also diagnosed (at age 16), but they caught it much sooner because Bonnie knew the symptoms of T1D. Yet, a year later, Jillian was feeling unwell again. They couldn’t figure out why until she was diagnosed with celiac disease, another autoimmune condition that is more common in people with T1D.

Bonnie’s family became involved with JDRF through the JDRF Walk to Cure Diabetes in Regina, SK, two years after Bryn’s diagnosis. As their family learned more about JDRF, they wanted to become more actively engaged as volunteers and supporters. They realized that advancements like insulin pumps, which had made Bryn’s T1D management easier, were made possible in part by JDRF-funded research.

“Thanks to JDRF’s contributions to research, our family is a happy success story,” Bonnie says. “But we still have more work to do. That’s why I decided to join JDRF Canada’s $100M Campaign to Accelerate by helping to fundraise for global research and thanking JDRF’s incredible donors through the Stewardship Cabinet.”

JDRF also informed Bonnie’s family about studies like TrialNet, which allowed them to screen their five other kids for T1D auto-antibodies. They discovered that their youngest child, Burke, was at a high risk of developing T1D. Thankfully, he is still T1D-free today at age 28 and may have the chance to delay its potential onset with emerging disease-modifying therapies.

Bonnie’s children are doing well today and have made her a proud grandmother. With fifteen grandkids, Bonnie would like to build on existing research to catch T1D early, keep it at bay, and stop it before it can start so they can live in a world without the disease. She hopes the research will advance so Bryn and Jillian no longer experience highs and lows (blood glucose) or need to monitor their blood glucose levels constantly. Whether through technology like hybrid closed-loop insulin pumps, stem cell transplants or immunotherapies, Bonnie believes we are close to cures.

“We’re on the verge; let’s make it better,” Bonnie says. “The cure for diabetes may not be the common definition of ‘cure,’ but we are so close to people with T1D being able to live independently of technology and insulin. Please know that with your financial assistance, we’ll quickly push this [T1D cure research] over the edge.”

Become part of JDRF’s exceptional community of philanthropists

Leadership gifts (of $5,000 or more) towards our campaign ensure groundbreaking research advancements to help improve the lives of people with T1D, like Bryn and Jillian, parents like Bonnie, and countless others impacted by this disease.

To learn more about how you can make a meaningful investment through ou

50-Day Challenge to Triple Donor Impact on Research

– Helen Keller, Disability rights advocate

Since our founding 50 years ago, JDRF Canada has helped fuel almost every advancement in type 1 diabetes (T1D) care and cure research by bringing together the T1D community, donors, researchers, and funding partners to work towards the same vision – a life without T1D.

Through our partnership with the federal government, the Canadian Institutes of Health Research (CIHR) matches all donor investments 1:1 toward high-impact Canadian T1D research grants, meaning donations to this partnership make double the impact on critical T1D research.

3X Match

Over 50 days, double the impact will become triple the impact thanks to the incredible generosity of one of our dedicated board members, who is matching all Campaign to Accelerate gifts ($5,000 and up) to the JDRF-CIHR Partnership to Defeat Diabetes up to $1M. With donor support help, we can turn $1 million into $3 million for groundbreaking research in Canada. 

This 3X Triple Match funds innovative projects in cell therapies, precision medicine, mental health, and nationwide T1D screening that advance care, early treatment, and promising pathways to T1D cures.

To learn more or make a 3X match leadership gift, contact Kim Lacombe.

LEARN MORE  

In Cures

Dr. James Shapiro is exploring whether a person’s own blood cells (reprogrammed into islet-like cells for transplant) can be used as the basis for therapy instead of donor tissue.

“I’m very excited about the progress of T1D research, especially within the last five years. But I believe that a cure is really within all our grasps. It’s going to require intense collaborative scientific effort and a lot of funding, but I firmly believe this is possible and will happen,” says Dr. James Shapiro, University of Alberta.

Dr. Cristina Nostro is testing gene-edited stem cell-derived islets for transplant that would not require the immunosuppressive drugs typically needed in cell replacement procedures.

“In the last 20 years, we’ve learned how to differentiate stem cells [into beta cells], and now we’re moving them to the clinic, and they’re giving us the results we want. The future is bright. I’m super excited,” says Dr. Cristina Nostro, University of Toronto.

In T1D Management

Dr. Farid Mahmud recently published his trial results showing that a drug called Dapagliflozin can improve glucose control and kidney health in youth with T1D. Dr. Mahmud is also leading the EVERYONE study, which examines the impact of diversity on diabetes management in youth, intending to personalize care for better outcomes.

“We’re looking at how we can optimize care and prevent complications. We work with patient partners – families and parents – and all our studies are designed with these partners to develop the best ideas relevant to care,” says Dr. Farid Mahmud, SickKids.

In Mental Health

Dr. Holly Witteman is creating a research-based national peer support program led by people with T1D to improve the mental health and quality of life of the T1D community.

“As a scientist who has lived with type 1 diabetes since childhood, I know how important it is to be able to connect with others who really understand life with T1D. The CommuniT1D project aims to provide helpful, sustainable peer support for people living with T1D and their families across Canada so that no one has to feel alone,” says Dr. Holly Witteman, Université Laval.

In Early Detection

JDRF and the CIHR launched a nationwide T1D screening research consortium last year, hoping to implement general population screening to help eliminate life-threatening diagnosis complications and introduce future early intervention therapies to delay T1D onset.

“This project is near and dear to my heart because my son was diagnosed with type 1 diabetes when he was just two years old. He was extremely sick, and his body was weak. Life changed, and I had no idea there was even a possibility of T1D in our family, being affected by the 60s Scoop. I hope to identify barriers and provide resources while giving diabetes support and fostering relationships between Indigenous communities and researchers,” Sasha Delorme, Diabetes Action Canada, Indigenous research lead, JDRF-CIHR CanScreenT1D.

Collectively, the projects donors fund through the JDRF-CIHR Partnership make a profound impact now while supporting future T1D breakthroughs.

JDRF is working with its Campaign to Accelerate volunteer leaders to maximize this remarkable triple-match opportunity, which will drive significant advancements in Canadian research and positively affect the lives of nearly 300,000 people living with T1D nationwide.