Testing a new treatment to lower blood glucose in people with type 1

Professor Alexander Miras is running a small trial at the University of Ulster in Northern Ireland. He wants to find out if alpha-melanocyte stimulatory hormone (α -MSH) increases the amount of glucose absorbed by muscle in people with type 1. He also aims to understand how α-MSH works to see if it has potential as a new treatment for type 1.

Why is Breakthrough T1D UK funding this research?

We know that keeping your blood glucose levels within a target range is a challenge and many people struggle with hypers. In the long term, high blood sugar levels can lead to complications of diabetes such as damage to your kidneys and eyes. Often, treatments to help lower blood sugar in people with type 1 come will risks of hypoglycaemia and diabetic ketoacidosis (DKA). Alex thinks α-MSH may be able to reduce blood glucose without these potentially dangerous side effects. Alex’s research will provide vital evidence as to whether α-MSH holds promise as a potential new treatment alongside insulin.

What is alpha-melanocyte stimulatory hormone?

The hormone α-MSH is naturally released by our brains and is involved in the process of colouring hair and skin. As part of his previous Breakthrough T1D UK-funded project, Alex found that α-MSH can also lower blood sugar levels. He showed that giving animals and healthy humans is safe and effective in reducing blood sugar without causing hypos. The hormone does this by increasing the amount of sugar that is taken up by muscles.

What will happen in the research project?

Alex’s Breakthrough T1D UK-funded study will consist of two separate trials. In the first experiment, 24 adults with type 1 will undergo a glucose clamp procedure. During the clamp, the participants will receive glucose, insulin and either α-MSH or a placebo (salt solution) to measure how much blood sugar is taken up by muscles.

In the second trial, Alex will give nine people with type 1 and nine people without type 1 a sugary drink along with an infusion of either α-MSH or the salt solution placebo. A different group of six people with type 1 will be part of the trial but will not have the sugary drink or any infusions, to act as a control group. The research team will take small samples of leg muscle from all 24 people who took part. They will analyse the samples (known as biopsies) in their state-of-the-art laboratories to find out exactly how α-MSH works in muscle to reduce blood sugar.

Sharing muscles samples

As well as shedding light on how α-MSH works, Alex’s analysis will generate detailed information on how muscles take up glucose from the bloodstream in people with type 1. Alex will make these muscle samples available to other scientists around the world to develop new treatments for type 1.

How could this research help people with type 1 diabetes?

This research could lead to a new treatment for people with type 1 to be used alongside insulin to help manage blood glucose levels. It could help lower the risk of type 1 complications by helping people stop their blood sugar levels getting too high. Reducing the long-term risk of complications would help reduce anxiety in people with type 1. Alex hopes α-MSH will have the power to lower blood glucose levels without causing increased hypos or weight gain. If the results from Alex’s small trials are promising, he will progress to developing and optimising α-MSH to treat type 1.

Is Breakthrough T1D UK funding any other research like this?

We are also funding Professor Timothy Barrett to conduct The SMILE Trial, a clinical trial testing semaglutide in young people with type 1. Semaglutide is another drug that helps lower blood glucose and is already approved for adults with type 2 diabetes. The clinical trial will involve 230 people with type 1 between the ages of 10 and 24 years old.