I have a four year son with type 1 diabetes (diagnosed just before his third birthday) and two daughters (also four years old) who do not have diabetes. Understandably, I am concerned about the increased genetic risk they carry for type 1 diabetes. I read about the niacinamide studies in New Zealand and the preliminary conclusions that it delayed the onset of insulin dependence by up to eight years. I know this study has not yet been completed. What do you think of giving my daughters niacinamide supplements? If so, what kind of dosage would be appropriate? Are there any other studies that hold promising results regarding delaying or reversing the onset of type 1 diabetes?

Just in the last few weeks, the results of ENDIT, a large and very thorough study of the effect of niacinamide in delaying insulin dependence in antibody positive first degree relatives of people with type 1A (autoimmune) diabetes, were published. Unfortunately, they showed no statistical benefit and just why the New Zealand study and another smaller one in which nicotinamide was combined with vitamin E came to more optimistic conclusions is not known. In any case, it would not be appropriate to start giving nicotinamide to your two daughters without first showing that one or both were antibody-positive.

There are however other ongoing studies and you might want to call 1-800-425-8361 to find out if your daughters might be eligible for the oral insulin part of the DPT-1 trial. I suspect that they are still too young, but they might be able to arrange an antibody screen if you were interested and at no charge There are indeed a number of other ongoing trials with the same objective, such as vaccination with a part of the B chain of the insulin molecule or with heat shock protein and using immunomodulatory drugs such as MMF. There are plenty of other ideas too, but they are still at the stage of using laboratory animals.

DOB