Insulin pill (tablet) may delay the onset of type 1 diabetes
Oral insulin is different from an injectable insulin. The natural insulin or injected insulin cannot be replaced with oral insulin. Oral insulin can not lower blood sugar (glucose) levels and it cannot deliver glucose and oxygen from the bloodstream to cells.
The immune system attacks the beta cells causing a lower secretion of insulin and trigger type 1 diabetes (juvenile diabetes). Researchers think that the peptides of the oral insulin (after digestion) might dampen the autoimmune attack on the insulin-producing beta cells present in the pancreas.
But the largest study on the effects of the oral insulin in the prevention of type 1 diabetes shows that the onset of type 1 diabetes in children cannot be prevented with an oral insulin pill. But an oral insulin pill could delay the onset of type 1 diabetes in some children.
Researchers have conducted trials on 560 children from nine countries with an average age of eight years, who are at a high risk (that is the relatives of the child with at least two autoantibodies including glucose tolerance and insulin autoantibodies) of type 1 diabetes. All the participants were white, enrolled between March 2, 2007, and December 21, 2015. Sixty percent of them were male. They conducted a follow-up study until December 31, 2016.
They divided the participants into two groups. They gave 7.5 milligrams of oral insulin pills for the participants of the first group and placebo for the participants of the second group. They conducted an oral glucose tolerance test every six months to diagnose type 1 diabetes for a period of 2.7 years.
The study shows type 1 diabetes in the participants taking oral insulin was 28 percent and in the participants taking the placebo was 33 percent. But a five percent difference between the two groups was statistically insignificant or the difference was not strong enough to draw a conclusion.
But among children with low insulin secretion, researchers observed a delay of 2.5 years (31 months) in the onset of type 1 diabetes with oral insulin pill when compared with a group of children under the placebo.
Researchers say that an oral insulin pill may not prevent the onset of type 1 diabetes among children. But they want to see whether the higher dosage of oral insulin pill could prevent type 1 diabetes.
Lead author of the study was Dr. Carla J. Greenbaum, MD, chair of Diabetes TrialNet. She is also a director of the diabetes program, Benaroya Research Institute, Seattle. The study was published on November 21, 2017, in the Journal of the American Medical Association (JAMA). Title of the article was "Effect of Oral Insulin on Prevention of Diabetes in Relatives of Patients With Type 1 Diabetes. A Randomized Clinical Trial."
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Published by Jammi Vasista, Chennai, India.