Verapamil SR in Adults With Type 1 Diabetes

Prior treatment

• Require use of immunosuppressive agents including chronic use of systemic steroids
• Current or ongoing use of non-insulin pharmaceuticals that affect glycaemic control within prior 7 days of screening
• Use of any other investigational drug in the previous 30 days and/or intent on using any investigational drug for the duration of the trial
• Concomitant medication known for significantly inducing or inhibiting CYP3A4 and/or glycoprotein-P metabolism

Other illness

• Have active signs or symptoms of acute infection at the time of screening
• Have evidence of current or past human immunodeficiency virus (HIV), Hepatitis B or Hepatitis C infection
• Have a history of malignancies other than skin
• Known hypersensitivity to Verapamil or to any of its excipients
• Hypotension (of less than 100mmHg systolic), sick sinus syndrome (except patients with a functioning artificial pacemaker), uncompensated heart failure or severe left ventricular dysfunction; marked bradycardia (less than 50 beats/minute), atrial flutter or atrial fibrillation in the presence of an accessory bypass tract (e.g. Wolff-Parkinson-White syndrome), hypertrophic cardiomyopathy, acute myocardial infarction, attenuated neuromuscular transmission (e.g. by myasthenia gravis, Lambert-Eaton syndrome, advanced Duchenne muscular dystrophy)
• Any condition that in the investigator's opinion may adversely affect study participation or may compromise the study results

Lab values

• Be immunodeficient or have clinically significant chronic lymphopenia: Leukopenia (\< 3,000 leukocytes /µL), neutropenia (\<1,500 neutrophils/µL), lymphopenia (\<800 lymphocytes/µL), or thrombocytopenia (\<100,000 platelets/µL)
• Have any complicating medical issues or abnormal clinical laboratory results that may interfere with study conduct, or cause increased risk to include pre-existing cardiac disease, chronic obstructive pulmonary disease (COPD), sickle cell disease, neurological, or blood count abnormalities as judged by the investigator
• History of liver insufficiency or laboratory evidence of liver dysfunction with aspartate aminotransferase (AST) or alanine transaminase (ALT) greater than 3 times the upper limits of normal
• History of renal insufficiency or evidence of renal dysfunction with creatinine greater than 1.5 times the upper limit of normal
• Current use of Verapamil or other calcium channel blockers

Other

• Be currently pregnant or lactating, or anticipate getting pregnant during the 12 months study period
• Intake of grapefruit juice, licorice, St.John's Wort, cannabidiol, ginkgo biloba
• Substrate intake of CYP3A4 and/or glycoprotein-P metabolism, as judged by the investigator
• ECG second or third degree atrioventricular block; Incomplete branch block
• Current use of ß-blockers

• Have given written informed consent
• Age ≥18 and \<45 at consent
• Must have a diagnosis of T1D of within 6 weeks duration at screening (date of the first insulin injection)
• Must have at least one or more diabetes-related autoantibodies present at screening: GADA, IA-2A and/or ZnT8A
• Must have fasting C-peptide levels ≥100 pmol/L measured at screening
• Be willing to comply with intensive diabetes management