Currently, Insulin is an obligatory medication in T1DM. However, protection and preservation of residual β-cell function are of the highest priority because even miserable amounts of endogenous insulin are critical for maintaining proper diabetes control and complications avoidance.
DPP-4i family can help to reverse β cell damage. Proton Pump Inhibitors (PPIs) administration correlate with improved β cell function. GABA (Gamma Amino Butyric Acid) induces the suppression of glucagon, while stimulates β cells regeneration.
We report a two-year retrospective analysis of 56 Type 1 Diabetes (T1DM) patients treated with a combination of DPP4i, PPi, GABA. 19 of them fulfilled the protocol criteria. Parameters “Before-and-After” were compared. We also developed the “T1DM probability score”. Patients with more than five points were considered to suffer from T1DM. A/GAD antibodies were checked in 14 (74%) patients, of them - found positive in 10 (71.4%).
HbA1c decreased from 8.6±2.1 to 6.5±1.1 % (p-0,001). Insulin demands reduced from 26.0±23.4 to 10.8±14.4 units per day (p-0,003). BMI was stable: 23.4±2.5 kg/m2 before vs. 23.0±2.5 kg/m2 after (p-0,28). CGM showed Hypoglycemia TIR : 1.9±2.6 % vs.6.3±11.4 % (p-0,50). Normoglycemia TIR: 56,5± 32,8 vs. 62,1± 29,2% (p-0,064). Hyperglycemia TIR 41.6±33.1 vs. 31.6 ± 30.5% (p-0,02). Six patients (31.6%) stopped their insulin Injections for at least 26 weeks’period. Only one patient returned to insulin injections after 26 weeks .
This study demonstrates the efficacy of proposed therapy in T1DM. 31.6% of participants entered a long-term remission and became Insulin – free. All-in-all, this study is a proof of our concept.