Immune Interventions at Onset of Type 1 Diabetes — Finally, a Bit of Hope

This editorial highlights recent breakthroughs in immune interventions for newly diagnosed type 1 diabetes, emphasizing the preservation of residual β cell function. Two key trials are discussed: a phase 3 study of teplizumab (an anti CD3 monoclonal antibody) showing significant C peptide preservation at 78 weeks, and a phase 2 trial of baricitinib (a JAK inhibitor) demonstrating similar benefits over 48 weeks. While neither treatment improved glycated hemoglobin levels attributed to rigorous glycemic control in both trials teplizumab reduced insulin requirements, and baricitinib stabilized glucose variability. The author underscores the clinical value of residual insulin secretion for reducing complications and treatment burden, despite challenges like teplizumab’s adverse effects (e.g., cytokine release syndrome). The piece calls for tailored therapies, safety assurances, and exploration of combination strategies, marking a pivotal shift toward targeting autoimmune mechanisms alongside conventional diabetes management.

This editorial highlights recent breakthroughs in immune interventions for newly diagnosed type 1 diabetes, emphasizing the preservation of residual β cell function. Two key trials are discussed: a phase 3 study of teplizumab (an anti CD3 monoclonal antibody) showing significant C peptide preservation at 78 weeks, and a phase 2 trial of baricitinib (a JAK inhibitor) demonstrating similar benefits over 48 weeks. While neither treatment improved glycated hemoglobin levels attributed to rigorous glycemic control in both trials teplizumab reduced insulin requirements, and baricitinib stabilized glucose variability. The author underscores the clinical value of residual insulin secretion for reducing complications and treatment burden, despite challenges like teplizumab’s adverse effects (e.g., cytokine release syndrome). The piece calls for tailored therapies, safety assurances, and exploration of combination strategies, marking a pivotal shift toward targeting autoimmune mechanisms alongside conventional diabetes management.