Scientists in Canada are preparing to test if an aggressive diabetes treatment approach, based on cancer therapies, may aid people recently diagnosed with type 2 diabetes achieve disease remission. The REMIT Study, as it is known, challenges traditional diabetes treatments and is currently recruiting patients.
The study — being conducted by the Population Health Research Institute (PHRI), a McMaster University and Hamilton Health Sciences joint institute — is based on a PHRI pilot study showing that early aggressive treatment for type 2 diabetes resulted in up to 40% of its 83 enrolled patients achieving remission and needing no further diabetes medications for at least three months.
“For type 2 diabetes we have a wide array of new drugs, a wide array of new insulins, lots of choices, and we are doing our best with our family doctor colleagues, but we’re not winning,” Dr. Irene Hramiak, chief of the Centre for Diabetes, Endocrinology and Metabolism at St. Joseph’s Hospital in London, one of seven Canadian sites in the study program, said in a news release. “We still have 50 per cent of patients with type 2 diabetes who are not reaching their blood sugar targets. Unfortunately our patients still are suffering the complications — amputations, eye disease, dialysis and heart attacks from their diabetes. So we have to stop and ask maybe it’s our approach.”
Current treatment for type 2 diabetes patients begins with a single medication, then builds to more drugs and insulin as the disease advances. “We don’t start multiple drugs all at once,” explained Dr. Hramiak. “We take one at time. We wait until you run out of efficacy from that drug, which can take a variable length of time, and then we add a drug. But over the course of many years, there are lag periods and people spend a lot of time poorly controlled rather than well controlled because of the progressive nature of the disease.”
The study will determine if patients receiving intensive treatment — two drugs in combination plus insulin at bedtime — for three consecutive months can be induced into remission. It expects to enroll 152 people in Canada, including 25 at St. Joseph’s, diagnosed with type 2 diabetes within the past eight years. People interested in more information on the trial, or in possibly participating, can call 519-646-6100, ext. 65423.
“It’s quite innovative,” Dr. Hramiak said of the new study. “It’s really changing the disease and inducing remission rather than treating disease. It’s a huge difference to our overall approach.”