Stopping Diabetes Before It Starts

Claire Wirt, now 9, has been participating in a clinical trial for most of her life. She and her brother take part in TrialNet, an international study that aims to prevent, delay, and reverse the progression of type 1 diabetes. 

Before Claire was born, her mom, Correne Wirt, a pediatrician, noticed symptoms of type 1 diabetes in her niece. That diagnosis led the Wirts to the TrialNet Center at Yale, led by Kevan Herold, MD.  Dr. Herold’s research takes him from the laboratory to patients in his quest to understand the mechanisms of diabetes and develop new treatments based on these discoveries.  “The question we’re addressing in the clinic now, is whether we can actually stop diabetes from occurring in people who are going to develop the disease,” he says.

At first, Claire and her brother had yearly blood tests to assess antibodies that predict the development of type 1 diabetes. For the first two years, Claire tested negative and the Wirts breathed a sigh of relief. But when she was four, the tests showed that her body was making the autoantibodies, that indicate a high risk of developing diabetes. 

By examining the data from other patients like Claire, Dr. Herold predicts that she now has a 75 percent risk of developing type 1 diabetes within the next five years. “We know it’s coming,” her mom says. “For years, her risk has been increasing and we’ve always asked if there was anything we could do.”

Once it became clear that Claire was going to develop diabetes, she became eligible to participate in the study in which she received an infusion of either a placebo or an agent that may prevent type 1 diabetes.  Her parents knew that even if she was given the placebo, in terms of developing diabetes, she would be no worse off than if she didn’t participate in the study. If she was among those given the medication, however, there was a chance that it could stave off the disease, even if only temporarily. “This was the first thing that came along that provided us some hope,” says Correne.

After careful consideration and discussion, she and her husband decided Claire should take part in the trial. “As a doctor, I understand that it’s really important to move the science forward,” says Correne. Still, the decision to participate was ultimately left to Claire. “I wanted to help other children like me not to get diabetes and also maybe find a cure for people who already have diabetes,” she explains.

Dr. Herold is following Claire to see if she develops diabetes. “Many patients come to an academic center such as ours because they know that these types of studies are going to be available to them and they’re looking for the most advanced, cutting-edge research that might be useful to them,” he says. From his perspective, Claire is a hero, one of many who are willing to participate in clinical research to help both themselves and others.

If and when Claire does develop type 1 diabetes, her parents are glad to know there are other studies - such as one that is testing an artificial pancreas - that could benefit their daughter. “When we get to that point, we will be enrolling in whatever study is going on at the time,” says her mom. “After our experience at Yale, I’d go back there in a heartbeat.”

Correne Wirt, Claire Wirt and Grandmother

Mom Correne, Claire and Claire's grandmother

“I wanted to help other children like me not to get diabetes and also maybe find a cure for people who already have diabetes.”