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Question:

Our son is enrolled in the Barbara Davis Center for his diabetes; we gave our daughter (who doesn't have diabetes) the BCG vaccination at 9 months, and she continues to be autoantibody negative.

I am interested because the Israeli studies I read when we found that our daughter had the 3/4 allele combination indicated a much higher efficacy rate in preventing Type 1 if given before the autoantibody process starts.

As far as I know, no one else is pursuing a study or following up on this. It seems that there must be other families who have also given the BCG vaccination (perhaps for other reasons) and it would be interesting to look at the outcome.

Answer:

Attempts to modify the course of Type 1 diabetes after the clinical onset have been uniformly disappointing and that goes for BCG as well as all the other agents. Going one stage earlier and trying to intervene after antibodies have developed, but before the onset of insulin insufficiency has shown that both small doses of insulin by injection or nicotinamide by mouth seem to significantly delay the clinical phase. As you probably know a new trial has now been started using oral insulin.

Plans are underway for the next stage which will be to select a population that are at high risk either as a result of HLA typing or because they have first degree relative with Type 1 diabetes, but have not yet developed antibodies. A variety of interventions will be used to try to diminish the subsequent incidence of insulin dependence.

My guess would be that BCG will not rank high as a possibility for theoretical reasons and that more probably oral insulin or a peptide of the B chain of insulin subcutaneously will be tried first.

DO'B

Original posting 4 Jan 97

  
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Last Updated: Tuesday April 06, 2010 15:08:52
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