Exploring Verapamil's Potential to Slow Progression of Type 1 Diabetes

A recent study presented at the European Association for the Study of Diabetes (EASD) Annual Meeting highlights the potential of verapamil, a well-known calcium channel blocker, in preserving beta-cell function in individuals newly diagnosed with type 1 diabetes (T1D). The Ver-A-T1D trial examined whether daily administration of slow-release (SR) verapamil at 360mg could influence disease progression.

Type 1 diabetes occurs when the immune system mistakenly attacks insulin-producing beta cells in the pancreas, leading to insufficient insulin levels and elevated blood sugar. Traditionally diagnosed early in life, T1D quickly requires lifelong insulin replacement. Previous research suggested that overexpression of certain proteins contributes to beta-cell death, and verapamil could help by preventing this overexpression.

Led by Professor Thomas R. Pieber from the Medical University of Graz, Austria, the study involved 136 adults across six European countries. Participants were randomized into verapamil or placebo groups in a multicenter, controlled trial, with recruitment ending in May 2024. Verapamil, a drug with over five decades of use for cardiac conditions and approved by the FDA and EMA, was studied for its potential to delay beta-cell decline.

The primary outcome measured was the stimulated C-peptide response during a 2-hour mixed meal tolerance test at 12 months, a marker of beta-cell function. Although the results narrowly missed statistical significance, they showed promising trends indicating some preservation of beta-cell activity. A per-protocol analysis revealed statistically significant results, supporting the biological plausibility of verapamil's protective effect.

Secondary outcomes, including blood sugar control as measured by HbA1c, improved only during the initial six months. Glycemic control, insulin requirements, and continuous glucose monitoring were similar between the groups, and the medication was well tolerated. Mild, reversible side effects such as slight heart rhythm issues and slow heartbeat were observed, but no serious adverse events occurred.

The study was designed with an expected decline in beta-cell function based on previous data, but actual decline in the placebo group was less than anticipated, indicating slower disease progression in adults and limiting the statistical power of the trial to detect significant differences.

Professor Pieber emphasized that due to its safety, affordability, and non-immunosuppressive mechanism, verapamil remains an attractive candidate for combination therapies targeting beta-cell preservation. Upcoming analyses will focus on the 24-month follow-up and long-term outcomes of continuous verapamil use, which could provide deeper insights into its efficacy. The research team is also exploring combinations with immune-modulating agents to more effectively halt T1D progression.

This study enriches the ongoing search for interventions that can delay or prevent the progression of type 1 diabetes, offering hope for new therapeutic strategies in managing this chronic condition.

Source: https://medicalxpress.com/news/2025-09-potential-effects-verapamil-diabetes.html