MINNEAPOLIS/ST. PAUL (02/24/2023) — Published in JAMA, a University of Minnesota led study shows that verapamil, a drug commonly used to treat high blood pressure and heart conditions, can have a beneficial effect on the pancreas in children with newly-diagnosed type 1 diabetes (T1D).
Results of the CLVer clinical trial showed that oral verapamil taken once a day improved the pancreas’ insulin secretion by 30% over the first year following diagnosis of T1D when compared with a control group that received a placebo.
“The beneficial effect of verapamil observed in the trial is extremely exciting,” said Antoinette Moran, MD, the study’s principal investigator and professor at the University of Minnesota Medical School. “Although we don’t know whether the beneficial effect of verapamil on insulin secretion by the pancreas will be sustained once treatment was stopped at 12 months, we do know that better pancreas function in the first year is associated with better long-term outcomes in type 1 diabetes.”
The University of Minnesota was one of six pediatric diabetes centers in the U.S. that participated in the study. The trial included 88 children 8 to 17 years old who started the trial within 31 days of their T1D diagnosis. Participants were monitored for known side effects of verapamil, including effects on the heart, blood pressure and liver function. The study found that verapamil was well tolerated and very few of these side effects occurred.
In addition to evaluating verapamil, the trial also assessed whether an intensive glucose management approach that included use of an automated insulin delivery system to try to get glucose levels as close to normal as possible could have a beneficial effect on the pancreas’ insulin secretion. As reported in a companion paper in JAMA, much better glucose levels were achieved with this approach compared with standard care that included use of continuous glucose monitoring; however, a benefit on the pancreas was not observed. Nevertheless, the glucose levels achieved could have long-term benefits in reducing complications of diabetes.
“The fact that verapamil is low cost and readily available, is taken orally once a day, and has a very favorable safety profile makes it a very appealing treatment for children and adults who are diagnosed to have type 1 diabetes” said Dr. Moran.
Funding was provided by JDRF, while Dexcom, Medtronic, and Tandem Diabetes Care provided devices and supplies used in the study.
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The University of Minnesota Medical School is at the forefront of learning and discovery, transforming medical care and educating the next generation of physicians. Our graduates and faculty produce high-impact biomedical research and advance the practice of medicine. We acknowledge that the U of M Medical School, both the Twin Cities campus and Duluth campus, is located on traditional, ancestral and contemporary lands of the Dakota and the Ojibwe, and scores of other Indigenous people, and we affirm our commitment to tribal communities and their sovereignty as we seek to improve and strengthen our relations with tribal nations. For more information about the U of M Medical School, please visit med.umn.edu.
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Journal
JAMA
DOI
10.1001/jama.2023.2064
Method of Research
Randomized controlled/clinical trial
Subject of Research
People
Article Title
Effect of Verapamil on Pancreatic Beta Cell Function in Newly Diagnosed Pediatric Type 1 Diabetes
Article Publication Date
24-Feb-2023
COI Statement
Dr Forlenza reported serving as a consultant, speaker, or advisory board member for Medtronic, Dexcom, Abbott, Tandem Diabetes Care, Insulet, Lilly, and Beta Bionics and reported that his institution has received funding on his behalf for research grants from Medtronic, Dexcom, Abbott, Tandem Diabetes Care, Insulet, Lilly, and Beta Bionics. Dr McVean reported being an employee of Medtronic. Dr Beck reported that his institution has received funding on his behalf as follows: grant funding and study supplies from Tandem Diabetes Care, Beta Bionics, and Dexcom; grant funding from Bigfoot Biomedical; study supplies from Medtronic, Ascensia, and Roche; consulting fees and study supplies from Lilly and Novo Nordisk; and consulting fees from Insulet and Zucara Therapeutics. Dr Buckingham reported receiving grants, personal fees, and/or nonfinancial support from Medtronic, Tandem Diabetes Care, Insulet, Novo Nordisk, and Lilly and reported his institution has received research funding from Medtronic, Tandem Diabetes Care, Beta Bionics, and Insulet. Dr DiMeglio reported receiving consulting or advisory fees from Abata Therapeutics, MannKind, ProventionBio, and Zealand Pharma and study supplies from Dexcom. Dr Sherr reported receiving speaker honoraria from Lilly, Insulet, Medtronic, and Zealand Pharma; serving on advisory boards for Bigfoot Biomedical, Cecelia Health, Insulet, Medtronic Diabetes, JDRF (formerly the Juvenile Diabetes Research Foundation) T1D Fund, StartUp Health T1D Moonshot, and Vertex Pharmaceuticals; receiving consulting fees from Insulet and Medtronic; and reported that her institution has received research grant support from Medtronic and Insulet. Dr Clements reported receiving personal fees from Glooko Inc and receiving nonfinancial support from Dexcom and Abbott Diabetes Care. Dr Evans-Molina reported serving on advisory boards for ProventionBio, Isla Technologies, MaiCell Therapeutics, Avotres Inc, DiogenX, and Neurodon; receiving in-kind research support from Bristol Myers Squibb and Nimbus Therapeutics; receiving investigator-initiated grants from Lilly and Astellas Pharma; and having a patent for extracellular vesicle RNA cargo as a biomarker of hyperglycemia and type 1 diabetes and a provisional patent for a biomarker of type 1 diabetes (PDIA1 as a biomarker of beta cell stress). Dr Sims reported receiving compensation for educational lectures on type 1 diabetes screening from Medscape and the American Diabetes Association. Dr Messer reported receiving speaking or consulting fees from Dexcom, Tandem Diabetes Care, Capillary Biomedical (now owned by Tandem Diabetes Care), and Lilly; receiving grants from Insulet, Beta Bionics, and Tandem Diabetes Care; and being a current employee of Tandem Diabetes Care. Dr Ekhlaspour reported receiving consulting fees from Tandem Diabetes Care and Ypsomed Holding AG; receiving speaking fees from Insulet; and receiving research support from Medtronic and MannKind. Dr Van Name reported receiving research support from ProventionBio. Dr Kollman reported receiving grants from Dexcom and Tandem Diabetes Care. Dr Moran reported serving on advisory boards for Dompé Farmaceutici SpA, ProventionBio, and Abata Therapeutics; serving on a data and safety monitoring board for Novo Nordisk; and reported that her institution has received grant funding on her behalf from Abbott Diabetes, ProventionBio, Intrexon (now Precigen), and Caladrius Biosciences and study supplies from Novo Nordisk, Medtronic, and Abbott Diabetes. No other disclosures were reported.
