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Nicotinamide treatment in subjects at high risk of developing IDDM improves insulin secretion
R Manna1, A Migliore, L S Martin
1Department of Internal Medicine, Catholic University, Rome, Italy.
Abstract:
Nicotinamide (NCT) has been shown to be effective in preventing the onset of type 1 diabetes mellitus (IDDM) in mice with non-obese diabetic (NOD) and beta cell damage, mediated by the diabetogenic agents including streptozotocin. NCT therapy in man has been shown to have a beneficial effect on the remission phase of IDDM, and its use is safe. In this open pilot trial we therefore studied the effect of oral NCT administration on insulin secretion rate and islet-cell antibody (ICA) titres in IDDM high risk subjects. NCT (25 mg/10 kg bw) was administered in 6/13 high risk patients identified by a family screening programme. Those subjects tested after eight months without treatment showed a decreasing secretion in comparison to onset baseline (56,1 +/- 37.8 versus 35,5 +/- 12.2), whereas the treated subjects showed an increasing insulin secretion after treatment (26 +/- 10 versus 50.2 +/- 26.6), in spite of ICA persistence. Statistical analysis shows an increased insulin secretion in the treated group versus the untreated group (chi 2 = 3.899, P = 0.048). No side-effects were observed. We conclude that NCT may repair beta-cell function in high risk subjects too if damage is not too severe; furthermore, the effect seems not to be mediated by an immune mechanism.
Insights
Nicotinamide (NCT) may improve insulin secretion in individuals at high risk for type 1 diabetes mellitus (IDDM). This pilot study suggests NCT could help preserve beta-cell function before significant damage occurs.
Area of Science:
- Endocrinology
- Immunology
- Metabolic Diseases
Background:
- Nicotinamide (NCT) demonstrates efficacy in preventing type 1 diabetes mellitus (IDDM) in preclinical models.
- NCT therapy has shown positive effects and safety during the remission phase of IDDM in humans.
Purpose of the Study:
- To investigate the impact of oral NCT on insulin secretion rates and islet-cell antibody (ICA) titers in individuals at high risk for IDDM.
Main Methods:
- An open pilot trial involving 13 high-risk subjects identified via family screening.
- Six participants received oral NCT (25 mg/10 kg body weight).
- Insulin secretion and ICA titers were monitored over eight months.
Main Results:
- Treated subjects exhibited increased insulin secretion post-NCT administration (26 ± 10 to 50.2 ± 26.6).
- Untreated subjects showed a decrease in insulin secretion (56.1 ± 37.8 to 35.5 ± 12.2).
- Statistical analysis confirmed significantly higher insulin secretion in the NCT-treated group (chi² = 3.899, P = 0.048), despite persistent ICA.
Conclusions:
- Oral NCT may potentially repair beta-cell function in high-risk individuals, provided the damage is not too advanced.
- The observed therapeutic effect of NCT appears independent of immune mechanisms.