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March 6, 2001

Research: Causes and Prevention

Question from Portland, Connecticut, USA:

Our two year old son was diagnosed with type 1 diabetes at age 14 months, and we are now expecting our second child. I heard on the news that type 1 diabetes may be able to be prevented in siblings of kids who have diabetes by taking some kind of low dose insulin pill. Is this available yet? If so, how do we get it? If not, are there other ways of preventing diabetes in siblings? We're planning on asking our son'e doctor this same question, but would like more than one opinion.

Answer:

If you son is known to have type�1A or autoimmune diabetes then the chance of your second child being affected are only about 1:20. As he/she gets to be three years old you might call 1-800-425-8361 to see if they are still accepting cases into the oral part of the national DPT-1 trial. They would also arrange a diagnostic antibody test. I suspect though that the results will by then be known, and, if successful, oral insulin vaccination will be much more readily available. It is also possible that by then another form of insulin vaccination will be available, so far it has only succeeded in mice. See Bergerot I, Ploix C, Petersen J, Moulin V, Rask C, Fabien N, Lindblad M, Mayer A, Czerkinsky C, Holmgren J, Thivolet C. A cholera toxoid-insulin conjugate as an oral vaccine against spontaneous autoimmune diabetes. ( Proc Natl Acad Sci USA 1997 Apr 29;94(9):4610-4).

Also by that time, another approach using a fraction of the B chain of insulin may also have shown promise. It should be stressed however that in this sense vaccination refers to the use of insulin as an antigen after the autoimmune process is already in its earliest stages. There have been no trials yet in children who are genetically susceptible, but in whom the autoimmune process has not been triggered.

DOB