Combination therapy with lansoprazole and cholecalciferol is associated with a slower decline in residual beta-cell function and lower insulin requirements in children with recent onset type 1 diabetes: results of a pilot study

Abstract

Objective: To investigate the effects of combination therapy with cholecalciferol and lansoprazole on residual β-cell function and glycemic control in children with new-onset type 1 diabetes. Methods: Children aged 6-12 years with type 1 diabetes were allocated to receive cholecalciferol and lansoprazole (Group 1) or no treatment (Group 2). Children were maintained on their respective insulin regimens and kept records of blood sugar and insulin doses taken. Children were followed at three-month intervals for six months. Changes in mean fasting C-peptide and HbA1c levels, daily insulin doses, fasting blood glucose and mean blood glucose levels from baseline to end of the study were analyzed. Results: Twenty-eight children (14 per group) met the eligibility criteria. Fasting C-peptide levels decreased significantly from baseline to study end in both groups (mean decrease -0.19±0.09ng/mL and -0.28±0.08ng/mL, p=0.04 and p=0.001; Group 1 and Group 2 respectively). However, fasting C-peptide level drop was significantly smaller in Group 1 compared to Group 2 (30.6% and 47.5% respectively; p=0.001). Likewise, daily insulin doses decreased significantly in both groups (-0.59±0.14units/kg and -0.37±0.24units/kg respectively; p=0.001). All patients recruited completed the study. No adverse events were reported. Conclusion: Combined therapy with cholecalciferol and lansoprazole for six months was associated with smaller decline in residual β-cell function and lower insulin requirements in children with new-onset type 1 diabetes. Preliminary findings of this small-scale study need to be confirmed by larger studies. Registry of Clinical Trials: (www.ctri.nic.in) under number REF/2021/03/041415 N.

Repurposing lansoprazole to alleviate metabolic syndrome via PHOSPHO1 inhibition

“…LPZ has been reported to reduce body weight gain, improve glucose tolerance in HFD-fed mice 25 , 26 , ameliorate hepatic steatosis in the hypercholesterolemic rat model 27 , lower circulating glucose in the diabetic gerbil Psammomys obesus 28 , and synergized with antidiabetic medications to improve glycemic control 25 , 29 . Clinical studies have also reported that lansoprazole treatment improved glycemic control in diabetic patients 30 , 31 . However, the molecular mechanism for the metabolic benefits of LPZ remains largely unknown.…”

Type 1 diabetes prevention and treatment: Time to think outside the box

“…Another association that has shown promising results on T1D in nonobese diabetic mice and human studies is the combination of dipeptidyl peptidase 4 (DPP-4) inhibitors, gamma-aminobutyric acid, and proton-pump inhibitor (PPI), resulting in long insulin-free periods. 8,9 Reddy et al 10 showed a smaller decline in residual β-cell function and lower insulin requirements in T1D treated with lansoprazole plus cholecalciferol. Verapamil has been shown to delay the progression of T1D for at least 2 years after diagnosis, partially preserved stimulated C-peptide secretion, normalizing the serum levels of chromogranin A (a T1D autoantigen), proinflammatory interleukin-21, and T-follicular-helper cell markers.…”