I would like to know the current status of the TRIGR trial, and any other primary prevention trials. Have results been published from this trial regarding the relationship between cow’s milk and the development of type 1 diabetes?

The role of early exposure to cow’s milk in the pathogenesis of type�1A (autoimmune) is still controversial. In the DAISY study no effect was found. In the Finnish Trial to Reduce IDDM in the Genetically at Risk Study (TRIGR) there were differences in antibody response to bovine insulin during the first year of life; but no change in T-cell response. This study is reported in the October 2000 issue of the journal Diabetes.

There are other studies which are still much more positive about such a link including some that suggest that the trigger lies in a fragment of a specific cow’s milk protein which is not present in all species thus explaining some of the variability of results.

The two main secondary prevention trials ENDIT using nicotinamide and DPT-1 using insulin are just nearing the end of their course and no results have yet been published though other studies have shown that nicotinamide can defer insulin dependance in about 60% of new onset cases. I know of no completed trials of primary prevention though with the recent hugely increased understanding of the basis of autoimmunity. These are beginning.

DOB

[Editor’s comment: The results of the DPT-1 are due to be announced at the American Diabetes Association Scientific Sessions in June, 2001.

SS]