There are two main forms of diabetes: type 1, formerly called juvenile diabetes, and type 2, the most common form, formerly called adult-onset diabetes.
Type 1 diabetes is usually diagnosed in children and young adults, and symptoms often develop quickly and are more severe, according to the Mayo Clinic. Around 304,000 children and adolescents are among the 2 million Americans with type 1 diabetes, reports the American Diabetes Association (ADA). The Centers for Disease Control and Prevention in Atlanta estimates that 34 million adults in the United States, or 10.5 percent of the population, have diabetes and that adults with type 1 diabetes make up 5 to 10 percent of all cases diagnosed.
Type 2 diabetes is more common in people over 45 who are overweight or obese and who have high blood pressure or high cholesterol, among other factors, according to the Cleveland Clinic.
Both types of diabetes require lifestyle changes, such as monitoring glucose levels, eating a healthy diet, and exercising. Some diabetic patients, especially those in the advanced stages, need to take synthetic insulin regularly to manage their sugar levels.
Tzield should help patients like Ella, avoid insulin injections. “It’s so cool to be able to live a normal life,” Ella said of the results of the new drug.
Piedmont Columbus Regional Endocrinologist Dr. Steven Leichter treated Ella and his practice participated in Tzield’s clinical trials. He called the drug a life-changing and breakthrough in health care delivery, with the potential to completely eliminate diabetes in some patients.
“Maybe this drug can prevent a person from getting type 1 diabetes for the rest of their life. Preliminary data suggests it’s possible. This can alter the autoimmune process and prevent it from progressing,” Leichter said.
Piedmont Columbus Regional is one of the few facilities in the country to offer Tzield, which involves infusions for 14 consecutive days followed by constant monitoring. The medical facility was able to offer the treatment to Ella as it prepares to open a new children’s hospital capable of providing such infusions in the future.
A new screening strategy developed by the medical center will allow healthcare professionals to begin identifying eligible candidates to receive the infusion before they develop diabetes. Starting July 1, pediatricians and primary care physicians in Columbus and surrounding areas will be able to screen patients who may benefit from Tzield.
Jim Gavin, Atlanta endocrinologist, former The ADA president called Leichter’s work with Tzield extremely exciting.
“This is a step forward in precision medicine, and the fact that it’s happening in Columbus, Georgia, is just as exciting,” said Gavin, chief medical officer of Healing Our Village in Atlanta. More typical of large, research-driven medical centers, screening patients in a smaller community proves it can be replicated on a larger scale, he said.
Patients eligible for treatment are usually relatives of someone with type 1 diabetes. Patients must be at least 8 years old and have stage 2 type 1 diabetes. Stage 2 indicates that their body can still produce insulin. Eligible patients must also have at least two indicators of diabetes and have abnormal blood sugar levels.
Leichter said people with a family history of type 1 diabetes could be up to 15 times more likely to develop it.
Ella, who has stage 2 type 1 diabetes, qualified as a candidate for treatment when her 14-year-old brother, Alex, was diagnosed with stage 3 type 1 diabetes in December 2019. At stage 3, the disease is associated with significant health risks.
Leichter’s office participated in clinical trials, which included Alex, for the use of Tzield in early stage 3 type 1 diabetes. After these trials, doctors decided to test Ella for diabetes-related antibodies, thinking she might qualify for the drug based on ADA screening guidelines, and one popped up. They followed Ella for almost two years, during which time her condition began to deteriorate and she was at risk of developing diabetes.
A competitive gymnast, Ella said she previously worried about having to take breaks during her workout to have a juice or snack to regulate her sugar levels. She saw how Alex had to sit or lie down when his blood sugar dropped.
Alex, who relies on insulin, said he was glad to have participated in one of the first clinical trials of Tzield “so my sister could be more active.”
The siblings’ parents hope that Ella and other children like her will never have to take insulin and constantly monitor their diet. Luis Velez recalled how his son Alex becomes disoriented, shakes and cannot speak properly if his blood sugar is too high or too low.
“I deal with my son’s diabetes every day,” said their mother, Lorna. She was happy that her son’s participation in clinical trials could help others avoid his diabetic experiences. “It’s great that their world isn’t stressful.”
Define diabetes
Diabetes is a disease that prevents the body from producing the hormone insulin, which helps regulate the use of dietary sugar for energy. This disease can cause serious and even life-threatening complications, such as heart, kidney, and eye disease.
Type 1: A condition in which high levels of blood glucose (sugar) result from a lack of insulin. This disease occurs when the body’s immune system attacks and destroys insulin-producing cells in the pancreas, causing the pancreas to produce little or no insulin. Type 1 diabetes most often affects young people but can appear in adults.
º Stage 2: The body can still produce insulin, so patients at this stage do not need it injections.
º Stage 3: Associated with significant health risks, some of which can be life-threatening. Patients at this stage eventually require lifelong insulin injections.
Type 2: A condition in which high levels of blood glucose (sugar) result from either a lack of insulin or the body’s inability to use insulin effectively. Type 2 most often develops in middle-aged and older adults, but can appear in young people.
Common Symptoms of Diabetes: Frequent urination, feeling thirsty or hungry, extreme fatigue, blurred vision, slow-healing cuts or bruises. Type 1 may include weight loss, even if you eat more, and type 2 may include tingling, pain, or numbness in your hands or feet.
Sources: American Diabetes Association and Cleveland Clinic.