A world-first clinical trial has found a common drug used to treat rheumatoid arthritis can suppress the progression of type 1 diabetes in recently diagnosed patients.
Researchers at St Vincent’s Institute of Medical Research in Melbourne, Australia, discovered baricitinib can preserve the body’s own insulin production.
They described the finding as “a huge step-change” in how the condition is managed and treated and said their work “shows promise as a fundamental improvement in the ability to control type 1 diabetes”.
Type 1 diabetes is a chronic condition that causes a person’s blood sugar level to become too high because their body is unable to make insulin.
Their body’s immune system mistakenly attacks and kills the cells in the pancreas that produce the hormone, which means they are dependent on regular insulin injections in order to survive.
Professor Thomas Kay, who led the trial, said: “We wanted to see whether we could protect further destruction of these cells by the immune system.”
The scientists recruited 91 people, aged between 10 and 30 years old, to take part in the double-blind randomised trial.
It meant neither the researchers nor the volunteers knew who was taking baricitinib (60 people) and who was receiving a placebo (31 people).
All patients had been diagnosed with type 1 diabetes within the last 100 days and continued with their prescribed insulin therapy throughout the study.
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The researchers monitored their total daily dose of insulin, the amount of insulin produced in the body, as well as their blood sugar levels.
The results showed those in the baricitinib group were able safely and effectively to preserve their body’s own insulin production and suppress the progression of type 1 diabetes.
It is thought the drug works by dampening down the immune response mounted against insulin-producing cells in people with type 1 diabetes.
Professor Kay said: “Up until now, people with type 1 diabetes have been reliant on insulin delivered via injection or infusion pump.
“Our trial showed that, if started early enough after diagnosis, and while the participants remained on the medication, their production of insulin was maintained.
“People with type 1 diabetes in the trial who were given the drug required significantly less insulin for treatment.”
It is estimated around 8.4 million people across the world had type 1 diabetes in 2021, with numbers projected to rise to 17.4 million by 2040.
In the UK, around 8% of people with diabetes have type 1 diabetes.
Dr Faye Riley, research communications manager at Diabetes UK, said of the latest trial: “These findings show by tackling the root of type 1 diabetes – an immune system attack – an existing drug can help to shield the pancreas, in people recently diagnosed with type 1, so they can continue making more insulin for longer.
“This can give people with type 1 diabetes much steadier blood sugar levels and help to protect against serious diabetes complications down the line.
“Immunotherapies are edging us towards a new era in type 1 diabetes treatment, and could help us overcome a major hurdle en route to finding a cure for the condition.
“This trial takes us another step closer.”
The study was funded by JDRF, a non-profit organisation which focuses on type 1 diabetes research.
The research has been published in the New England Journal of Medicine.
“I was in the classroom and someone suddenly came in. I saw him, I saw the shooter. As soon as he entered, he’d started shooting. Six, five times. So I started running.”
We’re speaking with a man who survived when Rickard Andersson opened fire, killing 11 people, at an adult education centre in Sweden’s worst mass shooting.
“I fell over and he started shooting towards me and I dropped my phone as I ran off and managed to escape,” the witness says.
As he shares the visceral detail of his account, he becomes emotional as he describes losing friends before his eyes.
“It was very scary,” says the man, who asked not to be named.
“I saw him shoot others. So I’m having a really, really tough time right now. I haven’t been able to sleep.”
He came back to the scene of the attack on Wednesday – where he used to go to lessons each day – and felt unable to comprehend how a place of safety became a place of terror in a matter of minutes.
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Footage shows classroom on lockdown during shooting
The adult education centre in Orebro sits between two schools and many gathered at the police cordon the morning after the attack.
We watched as children lit candles with their parents before starting their day. At the cordon clutching his brown briefcase we meet Marcus Ahltun.
He’s the headteacher at one of the schools and had been in his office when he heard the gunshots next door and made the rapid decision to lockdown the school.
“I heard screams, and then I heard shots fired. I immediately decided that we needed to shelter in the school,” he told us.
Being metres away from the atrocity he said was “a surreal, numb feeling”.
Numb is how many have felt at the site today. Some came alone to pay their respects, some gathered in groups. We watched friends clutch and hold each other tightly.
Orebro is a university city and a young place with diverse communities.
People in the city and throughout the country are both mourning the loss of the victims and asking themselves how a gunman was able to enter an educational facility and kill.
A gunman who shot dead 10 people at an adult education centre had access to several weapons and had “major problems” at school, Swedish media have reported.
In an update on Wednesday, police said the perpetrator appears to have shot himself – and added they are still unclear on the motive.
Swedish media have named the attacker as Rickard Andersson, 35, who was said to have been unemployed for more than 10 years and attended a special class for people with Asperger’s and high-functioning autism, Swedish channel TV4 reports.
A hunting weapon for which he had a licence was found next to his body at the scene of the attack on Tuesday.
The head of the local police, Roberto Eid Forest, said the centre’s large premises meant it took a long time for officers to search the campus and ensure there were not any more victims.
Police heard gunshots when they arrived and initially thought they were being fired at, he added.
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The shooting started about midday local time at Campus Risbergska in the town of Orebro, about 200km (125 miles) west of the capital Stockholm.
The attack happened after many students had gone home following a national exam.
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Student describes chaos of Sweden school shooting
Students took shelter in nearby buildings and other parts of the campus were evacuated.
Officials said three women and two men, all with gunshot wounds, underwent surgery at hospital. All were in a serious but stable condition after being admitted with life-threatening injuries. Another woman was treated for minor injuries and was stable.
Two of the victims were in intensive care, a health official said, and all the victims were over the age of 18.
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2:21
Sky’s Ashna Hurynag reports from Orebro, Sweden in the wake of a mass shooting.
Police previously said the number killed could rise.
They said there were no warnings beforehand and they believe the perpetrator acted alone. The force has not said if the man was a student at the centre.
The authorities said there were no suspected connections to terrorism at this point, but they have not suggested a possible motive for the attack.
Officers raided the suspect’s home after the shooting on Tuesday but they did not say what they found.
Andersson was reported to have not had any income from any job since 2015, while his performance at school was also reviewed as “problematic”, TV4 said, as he failed all subjects from the spring semester of grade eight and throughout grade nine.
Andersson went on to study an individual programme before attending a special class for people with Asperger’s and high-functioning autism at Wadkoping Education Centre in Orebro.
He passed in aesthetic activities and history but failed in all other subjects.
‘Blood everywhere on the floor’
Andreas Sundling, 28, was among those forced to barricade themselves inside.
“We heard loud bangs and first we thought people were fighting outside and maybe throwing chairs and tables, [but] then we heard people screaming,” he told Sky News.
“Then the people in my class realised that something is wrong. We closed all the doors to the classroom and we locked the doors and I barricaded the doors with tables and chairs.”
Mr Sundling said his class hid under the tables and he began thinking about his family, including his two-year-old daughter and six siblings.
The student said there was “blood everywhere on the floor” inside the centre and it was “crazy”.
The centre is for students over the age of 20, according to its website. It offers primary and upper secondary school courses, as well as Swedish classes for immigrants, vocational training and programmes for people with intellectual disabilities.
Sweden’s prime minister Ulf Kristersson said the tragedy is the worst mass shooting in the country’s history.
“Today, we have witnessed brutal, deadly violence against completely innocent people,” Mr Kristersson told reporters.
“This is the worst mass shooting in Swedish history. Many questions remain unanswered, and I cannot provide those answers either.
“But the time will come when we will know what happened, how it could occur, and what motives may have been behind it. Let us not speculate,” he said.
The country’s king Carl XVI Gustaf said the shooting was a “terrible atrocity”.
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The King and Queen of Sweden have visited the site of the worst mass shooting in the country’s history.
“We send our condolences tonight to the families and friends of the deceased. Our thoughts at this time also go to the injured and their relatives, as well as to others affected,” he said.
“My family and I would like to express our great appreciation for the police, rescue and medical personnel who worked intensively to save and protect human lives on this dark day.”
Fatal attacks at educational establishments in Sweden are very rare, with 10 killed in seven incidents between 2010 and 2022, according to the Swedish National Council for Crime Prevention.
Almost 3,000 people have been killed in fighting in the Democratic Republic of the Congo (DRC), the UN has said.
Vivian van de Perre, a senior UN official based in the city of Goma, said the “escalating violence” in the area has “led to immense human suffering, displacement, and a growing humanitarian crisis”.
Bodies are decomposing on the streets of Goma, with 2,000 more collected across the region.
Some 900 more bodies are in morgues, with Ms van de Perre saying her organisation “expects the number [of those killed] to go up”.
Hundreds of thousands more remain displaced, while thousands of criminals allegedly broke out from a Goma jail.
Ms van de Perre said there is huge pressure on water, food, shelter and sanitation and conditions are “really, really dire”.
The UN also fears possible disease outbreaks, and one lynching has been documented.
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“It is imperative that all parties cease hostilities and commit to political dialogue… and work towards a peaceful resolution to this crisis,” Ms van de Perre said.
Providing aid for displaced people has been made more difficult by US President Donald Trump’s move to shut down USAID, with the UN saying this is “hampering operations”.
The UN said that violence has continued to escalate despite the rebels M23 declaring a unilateral ceasefire on Monday.
The M23 rebels are backed by some 4,000 troops from neighbouring Rwanda, according to UN experts. They seized Goma in three days after fierce battles with Congolese forces.
The rebels gained ground in eastern DRC on Wednesday despite the ceasefire, taking control of a town 60 miles from the provincial capital of Bukavu.
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The Office of the Prosecutor of the International Criminal Court called on Wednesday for the presentation of information and evidence regarding atrocities committed in eastern DRC.
“The office will continue to investigate alleged crimes committed by any person, irrespective of affiliation or nationality and will not be limited to particular individuals, parties or members of specific groups,” the statement said.
Goma, which remains under occupation, is home to two million people and is at the heart of a region home to trillions of dollars in mineral wealth.
The M23 is the most potent of the more than 100 armed groups active in the area.
Experts and analysts have expressed concern that Rwanda aims to take control of parts of DRC to ensure access to minerals.
But Rwanda’s government has framed the conflict as the defence of ethnic Tutsis in eastern DRC from ethnic Hutu forces linked to the genocide in Rwanda three decades ago that killed some 800,000 Tutsis, moderate Hutus and others.
Rwandan forces have entered DRC in the past while asserting the same aim, helping to fuel what has become one of Africa’s longest-simmering wars, with millions of Congolese displaced.