GABA induces a hormonal counter-regulatory response in subjects with long-standing type 1 diabetes.

Espes D, Liljebäck H, Hill H, Elksnis A, Caballero-Corbalan J, Carlsson PO

BMJ Open Diabetes Res Care 9 (1) - [2021-10-00; online 2021-10-13]

Experimentally, gamma-aminobutyric acid (GABA) has been found to exert immune-modulatory effects and induce beta-cell regeneration, which make it a highly interesting substance candidate for the treatment of type 1 diabetes (T1D). In many countries, including those in the European Union, GABA is considered a pharmaceutical drug. We have therefore conducted a safety and dose escalation trial with the first controlled-release formulation of GABA, Remygen (Diamyd Medical). Six adult male subjects with long-standing T1D (age 24.8±1.5 years, disease duration 14.7±2.2 years) were enrolled in an 11-day dose escalation trial with a controlled-release formulation of GABA, Remygen. Pharmacokinetics, glucose control and hormonal counter-regulatory response during hypoglycemic clamps were evaluated at every dose increase (200 mg, 600 mg and 1200 mg). During the trial there were no serious and only a few, transient, adverse events reported. Without treatment, the counter-regulatory hormone response to hypoglycemia was severely blunted. Intake of 600 mg GABA more than doubled the glucagon, epinephrine, growth hormone and cortisol responses to hypoglycemia. We find that the GABA treatment was well tolerated and established a counter-regulatory response to hypoglycemia in long-standing T1D. Further studies regarding not only the clinical potential of Remygen for beta-cell regeneration but also its potential use as hypoglycemic prophylaxis are warranted. NCT03635437 and EudraCT2018-001115-73.

PubMed 34635547

DOI 10.1136/bmjdrc-2021-002442

Crossref 10.1136/bmjdrc-2021-002442

pmc: PMC8506884
pii: 9/1/e002442
ClinicalTrials.gov: NCT03635437