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Prevention or delay of type 1 (insulin-dependent) diabetes mellitus in children using nicotinamide
1Department of Paediatrics, School of Medicine, Auckland, New Zealand.
Insights
Oral nicotinamide may prevent Type 1 diabetes in high-risk children. A trial showed only 1 of 14 treated children developed diabetes, compared to all 8 controls, suggesting nicotinamide
Area of Science:
- Endocrinology
- Pediatric Diabetes Research
- Nutritional Intervention Studies
Background:
- Type 1 diabetes is an autoimmune condition.
- Early identification of high-risk children is crucial for prevention.
- Islet cell antibodies and impaired insulin release indicate high risk.
Purpose of the Study:
- To assess the efficacy of oral nicotinamide in preventing Type 1 diabetes onset.
- To evaluate nicotinamide's role in preserving pancreatic beta-cell function in at-risk children.
Main Methods:
- A controlled trial involving high-risk children (age < 16) with specific immunological and functional markers.
- Participants were selected based on islet cell antibody levels (≥80 IUs) and first-phase insulin release (<5th percentile).
- Comparison between a group receiving oral nicotinamide and an untreated control group.
Main Results:
- All 8 untreated control subjects progressed to diabetes.
- Only 1 out of 14 children receiving oral nicotinamide developed diabetes.
- A significant difference in diabetes onset between the treated and control groups was observed.
Conclusions:
- Oral nicotinamide demonstrates a potential preventive effect against Type 1 diabetes in high-risk children.
- The findings support the need for larger, randomized controlled trials to confirm nicotinamide's efficacy.
- Nicotinamide may be a viable strategy for preventing autoimmune diabetes in pediatric populations.
Abstract:
A controlled trial of oral nicotinamide to prevent the onset of diabetes mellitus in high risk children was conducted in two centres. The selection criteria were age less than 16 years, islet cell antibody greater than or equal to 80 IUs, and first phase insulin release less than 5th percentile. All of eight untreated control subjects have developed diabetes, whereas only 1 of 14 treated children has diabetes to date. This data suggests that nicotinamide has an effect in preventing Type 1 (insulin-dependent) diabetes and that randomized controlled studies are now indicated.