Some illnesses disrupt life as soon as they appear, without giving the body time to adapt. Type 1 diabetes is one of those which, within a few weeks, requires lifelong treatment. But researchers may have just shaken things up. For the first time, treatment of type 1 diabetes administered at diagnosis appears capable of slowing the destruction of insulin-producing cells. A breakthrough that transforms the way we view the first months of the disease.
The trial includes 91 participants aged 10 to 30, all diagnosed within the previous 100 days. For 48 weeks, they receive either a daily baricitinib 4 mg tablet or a placebo. Researchers regularly measure their ability to produce insulin, using the level of C-peptide in the blood, as well as the stability of their blood sugar levels via continuous sensors.
The results, presented in September 2025 at the congress of the European Association for the Study of Diabetes (EASD), confirm a positive effect of the treatment. Patients on baricitinib maintain better insulin production, experience fewer blood sugar fluctuations, and require slightly lower insulin doses. The study relayed by SciTechDaily specifies that side effects are non-existent, which reinforces the therapeutic interest of this approach from the first months following diagnosis.
What prolonged monitoring of patients on baricitinib reveals
Beyond the initial results, the researchers wanted to know if the benefits were maintained after stopping the treatment. A second follow-up phase, carried out up to 96 weeks, provides key elements. Upon discontinuation of baricitinib, insulin production drops, C-peptide levels collapse, and the differences between the treated and untreated groups become smaller.
At 48 weeks, participants on treatment had a C-peptide level of 0.65, compared to 0.43 for the placebo group. But at 96 weeks, these values converge at 0.37 and 0.26 respectively, showing that the protective effect disappears in the absence of the drug. At the same time, insulin requirements increase, and the time spent in a stable glycemic zone decreases.
The detailed analysis of these data did not make it possible to identify the predictive factors of response to treatment. Neither age, nor genetic profile, nor body mass index, nor the number of autoantibodies allows us to know in advance who will benefit the most from this approach. However, as EurekAlert reports, almost two thirds of patients treated with baricitinib still showed a positive response.
A treatment for type 1 diabetes that paves the way for prevention
For the researchers behind the study, these results mark a major breakthrough. Baricitinib could become the first oral treatment capable of intervening early, safely, to slow beta cell loss. Ultimately, this would allow patients to remain independent of insulin for longer, or even postpone the full onset of the disease.
Researcher Michalea Waibel, who coordinates the project from the St Vincent Medical Research Institute in Fitzroy, points out that this approach has a double advantage. The treatment is easy to take, well tolerated, even in children, and acts directly on the autoimmune mechanisms at the origin of the pathology. She believes that earlier treatment, in people identified as at risk using biological or genetic markers, could even prevent the disease from taking hold.
New phase III clinical trials are expected to confirm the interest of baricitinib in this preventive perspective. If these results are confirmed, the treatment could therefore be approved for type 1 diabetes within five years. In the meantime, this advance is already redefining the therapeutic landscape of a disease hitherto considered irreversible from the appearance of the first symptoms.
