Is there any news on the results of the INGAP trial? I know Proctor and Gamble is putting a lot of funding into the GMP Companies research and development of INGAP. That seems to be a positive sign towards its potential. If it were to work, the INGAP would seem to be the best way to cure diabetes, no transplantation or immunosuppression. What is your opinion of the INGAP peptide as a cure? Are results available for The European Nicotinamide Diabetes Intervention Trial? Has any evaluation been done on Niacinamide’s effectiveness on LADA patients?

There continues to be occasional reports on islet cell regeneration in mice using INGAP or INGAP peptide, but to date I have neither found nor heard of any reports on the clinical studies. This molecule is one of a little understood family that have a role in this process.

The problem remains though that any regenerated cells in type 1A (autoimmune) diabetes or Late-onset Autoimmune Diabetes of Adulthood (LADA) would be expected to be vulnerable to the latent autoimmune process because they would be genetically identical with the host. In type 2 diabetes the problem would be to develop sufficient new islet cells to overcome the problem of insulin resistance.

The experts I talked were not optimistic about this approach, and for my own part, I think that the best hope for a ‘cure’ will first of all be in a durable glucose sensor that can be linked to a insulin pump. A trial of this is underway in Europe.

On a more permanent basis I believe that the best hope is for the development of some form of surrogate beta cells that can be transplanted in a single injection under cover of a greatly attenuated program to induce tolerance. Both these themes are being actively investigated.

The results of ENDIT, the Europaean study on the use of nicotinamide to defer insulin dependance in type I antibody positive people with prediabetes were presented this week in Budapest. Sadly they showed that the intervention, as with that of subcutaneous insulin in the US, DPT-1 study, had no effect.

DOB

[Editor’s comment: See New phase of INGAP research to begin.

SS]