A randomised, double-blind, placebo-controlled phase 2 trial tested BCG in long-standing type 1 diabetes, with follow-up to 8 years. HbA1c fell 7.04% at year 5 (P=0.0006) and 12.84% at year 8 (P=0.0001) with BCG, but not on placebo. Average insulin dose fell only in the BCG arm (P=0.024), as did blood sugars on continuous glucose monitoring (P=0.0189). Time in the normal range of 70-99 mg/dL rose by up to 183.7% over baseline (P=0.0391). C-peptide, a marker of insulin production, stayed negligible, indicating no pancreatic contribution. The number randomised is not reported, and HbA1c is presented as percent change from baseline rather than absolute values.
Why it is interesting: A generic, widely available vaccine produced durable glycaemic change in type 1 diabetes without any recovery of insulin secretion. The mechanism claimed is metabolic rather than pancreatic.
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