How a pioneering diabetes drug offers hope for preventing autoimmune disorders

Her sister’s life-threatening experience with diabetes was a wake-up call for Mikayla Olsten.

In 2016, when Olsten was 14 years old, her youngest sibling Mia landed in intensive care with failing kidneys and fluid in her lungs. It was ketoacidosis, a complication of type 1 diabetes (T1D) that is often the first sign that the body is not making enough of the sugar-regulating hormone insulin. Blood glucose levels spike, as do toxic waste products, throwing organ function into disarray.

Although she is healthy today, Mia is one of the estimated 9 million people worldwide who must deal with the daily grind of T1D, carefully managing their blood sugar and insulin levels.

And the scare prompted the Olsten family to test Mikayla for signs of diabetes that often precede disease symptoms. There was no previous history of T1D in the family, but siblings of those affected are at a greatly elevated risk.

The results came back positive for four of the five T1D markers that physicians look for, each a type of ‘autoantibody’ that tells the immune system to attack insulin-producing cells in the pancreas. Mikayla also had abnormal sugar metabolism — the disease process was already under way. Her odds of making it through secondary school without progressing to a diabetes diagnosis were about one in three, clinicians estimated.

Yet Mikayla, now 21 and studying exercise physiology at Brigham Young University–Idaho in Rexburg, continues to live diabetes-free — probably thanks to a drug called teplizumab.

Continue reading at Nature.