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Question:

From Golden, Colorado, USA:

My 3 1/2 year old son was diagnosed with Type 1 diabetes approximately one year ago. He uses very small amounts of insulin (approximately 5 units/day) so it is possible he's still honeymooning. I also have a six-month-old son who has not yet been tested. I have recently obtained a copy of an article from the April 1998 issue of the Natural Medicine Journal which advocates the use of Niacinamide to prevent the onset of diabetes and even reverse diabetes in newly-diagnosed children. In researching your previously answered questions I found that you addressed niacinamide previously, and suggested that it not be used, but I was wondering if this article presents any new research that would change your previous response.

Answer:

There have been many clinical trials of variety of immunomodulators that attempted to prolong the honeymoon period. The only one that was successful was a drug called cyclosporin and unhappily this proved to be damaging to the kidneys after a time. Large doses of nicotinamide alone or in combination with other free radical scavengers like vitamin E were tried on several occasions without success. In a New Zealand trial, nicotinamide was shown to significantly delay insulin dependance in Type 1A or autoimmune diabetes if it was given before the disorder became clinically apparent (i.e., in children screened for islet cell antibodies). A large trial called ENDIT is being carried out in Europe at this time to confirm these findings. You should discontinue niacin: it does not affect the immune process and can lead to unpleasant side effects.

Transplanting residual islet cells would not be effective because all the evidence is that they are already irrevocably damaged and that they would continue to destroyed by the pre-existing autoimmunity. There have been a small number of transplants from identical twins and again the transplanted islets were ultimately destroyed by the recipients' altered immune processes. The only real 'cure' for Type 1A Diabetes is of course transplantation; but despite the extraordinary complexity of both the autoimmune process and the phenomenon of rejection, progress is being made. Islet cell transplants of human cells can now be made to work; but tissue is limited and immunosuppression regimens are complex and carry significant risks.

What is important at this stage is to concentrate on developing the skills to keep blood sugars as close to normal as possible and so far you seen to have done very well indeed.

DO'B

Original posting 4 Jul 1998
Posted to Research: Causes and Prevention

  
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Last Updated: Tuesday April 06, 2010 15:08:58
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