Effects of insulin in relatives of patients with type 1 diabetes mellitus

The New England Journal of Medicine
Diabetes Prevention Trial--Type 1 Diabetes Study Group

Abstract

It is unknown whether insulin therapy can delay or prevent diabetes in nondiabetic relatives of patients with diabetes. In a randomized, controlled, nonblinded clinical trial, we screened 84,228 first-degree and second-degree relatives of patients with diabetes for islet-cell antibodies; 3152 tested positive; 2103 of the 3152 underwent genetic, immunologic, and metabolic staging to quantify their risk; 372 of the 2103 had a projected five-year risk of more than 50 percent; 339 of the 372 (median age, 11.2 years) were randomly assigned to undergo either close observation or an intervention that consisted of low-dose subcutaneous ultralente insulin, administered twice daily for a total dose of 0.25 unit per kilogram of body weight per day, plus annual four-day continuous intravenous infusions of insulin. Oral glucose-tolerance tests were performed every six months. Median follow-up was 3.7 years. The primary end point was a diagnosis of diabetes. Diabetes was diagnosed in 69 subjects in the intervention group and 70 subjects in the observation group. The annualized rate of progression to diabetes was 15.1 percent in the intervention group and 14.6 percent in the observation group. The cumulative incidence of diabetes was similar ...Continue Reading

Associated Clinical Trials

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Nov 11, 2020·Current Diabetes Reports·Jeniffer D Loaiza NaranjoEmma E Hamilton-Williams
Sep 11, 2019·Molecular Metabolism·Sahar Usmani-BrownKevan C Herold
Aug 19, 2011·Endocrine Practice : Official Journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists·Aakash AggarwalRajesh K Garg
Apr 24, 2020·Advanced Drug Delivery Reviews·J Daniel GriffinCory J Berkland
Feb 8, 2021·Annals of the New York Academy of Sciences·Anneliese J S FlattMichael R Rickels
Jan 24, 2021·Immunology and Cell Biology·Silvia Rodriguez-FernandezMarta Vives-Pi
Feb 7, 2021·Immunology and Cell Biology·Chun-Ting J KwongBalasubramanian Krishnamurthy

Related Concepts

Teens
Diabetes, Autoimmune
Filiation
Intravenous Glucose Tolerance Test
Reactive Hypoglycemia
Hypoglycemic Effect
Subcutaneous Injections
Insulin B Chain
Islets of Langerhans

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