Cholesterol and blood pressure drugs help teens with diabetes

Researchers from the Children’s Diabetes Centre have had a lead role in a global adolescent Type 1 Diabetes study, finding drugs used to treat blood pressure and cholesterol in adults can reduce the risk of kidney disease in young people with diabetes.   

The four-year AdDIT (Adolescent Type 1 Diabetes cardio-renal Intervention Trial) study involved screening 4407 young people across three continents — Australia, the United Kingdom and Canada — with the aim of understanding more about the development of long-term kidney, eye and cardiovascular complications in adolescents with Type 1 Diabetes.

Professor Tim Jones, co-director of the Children’s Diabetes Centre at the Telethon Kids Institute and paediatrician at Princess Margaret Hospital, was the principal investigator for Australia, which involved screening 2000 young people at seven hospitals and recruiting 200 participants, including 40 in Western Australia. 

Professor Jones said AdDIT set out to examine the risks of complications during puberty and to find out if drugs used to lower blood pressure (ACE inhibitors) and cholesterol levels (statins) in adults could lessen the risk of kidney, eye and cardiovascular diseases in young people with Type 1 Diabetes.

“The trial was designed to measure the levels of a protein called albumin in participants’ urine, a marker for the risk of life-shortening complications,” Professor Jones said.

“Importantly, we found that it was possible to identify young teenagers who would be at risk of later heart and kidney problems and target them for preventive therapy. Those at higher risk were invited to join the trial, where they received either a single drug or a combination of the two.

“The results suggest that neither ACE inhibitors nor statins significantly reduced urine albumin levels but they did reduce early signs of kidney disease which is a really promising finding.

“The drugs were also very well tolerated by the participants and reduced blood pressure and cholesterol effectively.”

Cambridge University Professor David Dunger, lead researcher of AdDIT in the UK, said the therapies reduced harmful lipid levels and the risk of progression to microalbuminuria — the term used to describe higher levels of albumin in urine — both thought to be predictors of future risk for complications.

“The essential biological samples and data provided by the participants will continue to inform our future understanding and our options for effective therapies for this vulnerable group of young people with Type 1 Diabetes,” Professor Dunger said.

Professor Jones said researchers would continue to follow participants for up to 10 years to determine if early medication continued to protect the heart and kidneys from disease.   

“Future work is still needed to establish the full benefits of statins and ACE inhibitors in young people with Type 1 Diabetes,” he said.

The results from the AdDIT study, which was funded by JDRF, British Heart Foundation and Diabetes UK, were published in the prestigious New England Journal of Medicine recently. Read the full article here.