Nasal Insulin Doesn't Prevent Type 1 Diabetes in At-Risk Kids

September 23, 2008

Prophylactic administration of nasal insulin soon after birth does not prevent children with HLA genotypes and autoantibodies from developing type 1 diabetes, nor does it delay onset of the disease, according to research published online Sept. 23 in The Lancet.

TUESDAY, Sept. 23 (HealthDay News) -- Prophylactic administration of nasal insulin soon after birth does not prevent children with HLA genotypes and autoantibodies from developing type 1 diabetes, nor does it delay onset of the disease, according to research published online Sept. 23 in The Lancet.

Kirsti Nätö-Salonen, M.D., of the University of Turku in Finland, and colleagues checked cord blood samples from 116,720 infants and 3,430 of their siblings and identified 17,397 infants and 1,613 siblings with HLA-DQB1 susceptibility alleles; 11,225 infants and 1,574 siblings were then screened for diabetes-associated autoantibodies every three to 12 months. Then 224 infants and 40 siblings who tested positive for two or more autoantibodies were then randomized to receive daily intranasal doses of 1 unit/kg of short-acting human insulin or placebo for a mean 1.8 years.

In the insulin group, 49 out of 115 index children and seven out of 22 siblings developed diabetes, as did 47 of the 109 children and six out of 18 siblings in the placebo group, the investigators found. The study was terminated early because there was no benefit to using insulin, the researchers note.

"Ongoing studies need to establish whether an antigen-based approach (e.g., with glutamic acid decarboxylase alum) will prove helpful," the authors write. "New safe and effective prevention strategies need to be developed on the basis of the increasing information about the pathogenesis of type 1 diabetes that is accumulating from prospective surveys and other studies."

Novo Nordisk Foundation provided some of the funding for the study.

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