Type-1 diabetes (T1D) is a common condition affecting humans for many years. It is a diabetic disease with high blood sugar levels that cannot be regulated through the body’s homeostasis. The condition can be caused by a decrease in pancreatic beta cells, triggered by external stimuli or autoimmune responses. Beta cells are important for producing insulin, a hormone that lowers blood sugar levels. Additionally, T1D can be present from birth and may be inherited across generations.

For example, Tom is a diabetic patient born with an autoimmune response targeting his pancreatic beta-cells. What can his doctor do to treat his diabetes? The standardized care of type-1 diabetes is the regular muscular injection of insulin. However, many people with TID have poor blood sugar control despite injecting insulin and increased doses. This approach often carries a risk of low blood sugar level (hypoglycemia) and weight gain, both of which are associated with an increased risk of cardiovascular disease. As these patients are getting more resistant to insulin, a combination of insulin and antidiabetic drugs could be the best treatment. If Tom’s physician finds that Tom has already developed a resistance toward insulin, he would increase the dosage of insulin he gives him. Alternatively, there could be other solutions to save Tom.

Researchers have studied several anti-diabetic agents, drugs, and adipates, discovering that these substances could be an effective concurrent therapy with insulin. These do not only include metformin and SGLT-2, but Tom’s physician will focus on these two this time because luckily he has a good chunk of these drugs as his hospital recently restocked anti-diabetic drugs for Type-2 diabetes. Drugs for Type-2 diabetes can also help people who have Type-1 diabetes.

Metformin is an oral antidiabetic drug commonly used as a first-line drug for Type-2 diabetes treatment. However, it has been recommended for treating Type-1 diabetes, with many studies showing improved blood-sugar level control, as measured by reduced HbA1c levels. This effect has multiple mechanisms, including decreased hepatic glucose production, increased muscle glucose uptake, and increased hepatic and muscle glucose sensitivity to insulin. Although metformin did not cause severe hypoglycemia, the function of metformin in mild symptoms remains unclear. 

Additionally, SGLT-2 inhibitor is a recently developed antidiabetic drug first launched to treat Type-2 diabetes in 2013. However, some studies suggested that SGLT-2 inhibitors may help meet the needs of Type-1 diabetic patients. For example, it could reduce mean blood sugar by reducing variability in blood glucose levels and high blood sugar levels after meals without increasing low blood sugar levels. Also, it could reduce weight gain by decreasing the insulin dose used in combination with the drug.

After an in-depth investigation of Tom’s body condition, his physician gave him metformin in combination with insulin. As a result, Tom was cured and did not need to increase the dosage of insulin or frequency of injected insulin. The only thing he needs to do is to take another pill while injecting insulin. This could not only help him slow down his development of resistance toward insulin but also maintain a good shape in his cardiac vessels.

This is the story of Tom, a T1D patient who was saved by drug treatments for T2D. If you want to learn more about diabetes, please visit the American Diabetes Association.