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A Daily Dose of Insulin May Prevent Type 1 Diabetes in Kids

A spoonful, or so, of insulin could keep some kids at risk from ever developing type 1 diabetes. More studies are needed, but the idea looks promising.

By Fran Kritz

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Without insulin, glucose builds up to dangerous levels and can cause serious damage such as vision and kidney problems.
Without insulin, glucose builds up to dangerous levels and can cause serious damage such as vision and kidney problems.
Alamy

A new, international study on a small number of children ages 2-7 who are at risk for developing type 1 diabetes found that giving kids high doses of oral insulin, often used to treat diabetes, might prevent the disease from ever developing. The study, which was funded in part by the Juvenile Diabetes Research Foundation, was published in the April 21st issue of JAMA.

The study is important because about 160,000 children ages 20 and younger have type 1 diabetes, a disease that develops when the body’s immune system attacks and destroys the beta cells found in the pancreas. As a result, the body stops producing insulin.

Insulin is a hormone that’s needed by the body to convert glucose — a form of sugar the body makes from foods we eat — into energy. Without insulin, glucose builds up to dangerous levels and can cause serious damage such as vision and kidney problems.

What if We Could Prevent, Not Just Treat, Type 1 Diabetes?

Ezio Bonifacio, PHD, a professor at the Paul-Langerhans-Institut in Dresden, Germany, and the lead author of the study, says the idea behind the clinical trial was that perhaps, like allergy shots, giving insulin to children who are at risk for diabetes might help them build up a tolerance and keep the children’s immune system from destroying the cells. According to Dr. Bonifacio, the trial used higher doses of insulin for possible prevention of type 1 diabetes than had been used in previous studies. They selected 25 at-risk children and conducted the study at medical centers in Germany, Austria, the United States, and the United Kingdom.

RELATED: Researchers Surprised By Diabetes Numbers

More Testing is Needed

The researchers found that nearly all of the children who received the highest insulin doses had a protective immune response, while only a third of the kids on lower doses had a similar response. While the results don’t necessarily mean the children won’t develop the disease, the researchers found it promising enough to want to conduct additional trials.

In an editorial published in the issue of JAMA, Jay S. Skyler, M.D., deputy director for clinical research and academic programs at the Diabetes Research Institute at the University Of Miami Miller School of Medicine, said that the study “increases enthusiasm for cautiously moving forward with a study of primary prevention in genetically-screened children.”

The Future Looks a Little Brighter

The biggest question may be: "Is the treatment safe?" “While no therapy is benign, we know that insulin has a good safety profile,” says Jane Chiang, MD and senior vice president for medical and community affairs at the American Diabetes Association. With the number of type 1 diagnoses on the rise, a treatment that can help delay or prevent the onset of the disease is invaluable. Because children with type 1 diabetes must do blood tests to check their sugar levels frequently, “the disease is very challenging to manage, which is why preventing, delaying, or even attenuating the disease is so important,” says Dr. Chiang.

“The study needs validation and we need to bring the age of the participating children down to as young as six months,” says Bonifacio. There has been interest expressed in conducting a bigger trial, which could begin in the next couple of years, Bonifacio adds. And while he says it is not clear if a trial in adults would produce similar results, using a protein other than insulin may be effective in grownups.






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Date: 09.12.2018, 06:03 / Views: 93265