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June 15, 2017

Oral insulin therapy fails to prevent type 1 diabetes, but some see disease delay

In adults with two or more antibodies predicting the development of type 1 diabetes, treatment with daily oral insulin therapy did not prevent development of the disease, but a small subset experienced a 31-month delay in clinical diabetes development.

“It’s important to note, this [delay in disease development] was not the primary endpoint, nor the primary group, so overall, the [trial] results were negative,” Carla J. Greenbaum, MD, of the Benaroya Research Institute in Seattle, said during a press conference announcing the findings. “Nonetheless, this dramatic result in the secondary analysis remains something we wish to follow up on.”

In a previous randomized, placebo-controlled trial involving participants with what is often called “stage 1” type 1 diabetes — relatives of patients with type 1 diabetes with positive antibodies predicting the disease but normal glucose tolerance — treatment with 7.5 mg daily oral insulin did not delay or prevent the development of clinical type 1 diabetes in the cohort, Greenbaum said. However, in a post hoc analysis, researchers identified a subgroup with specific antibodies who did experience a delay in disease development compared with those assigned placebo.

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