Insulin pills may delay the onset of type 1 diabetes in some individuals
Oral insulin is different from injectable insulin. Natural insulin or injected insulin cannot be replaced with oral insulin. Oral insulin cannot reduce blood sugar or glucose levels in the bloodstream and it cannot deliver glucose and oxygen in the bloodstream to cells.
Researchers thought that the peptides of the oral insulin after digestion might dampen the autoimmune attack on the insulin producing beta cells present in the pancreas. Immunity attack on beta cells causes weakening of insulin production and triggers type 1 diabetes (juvenile diabetes) condition.
But the largest study done on oral insulin effects on preventing type 1 diabetes shows the onset of type 1 diabetes in children cannot be prevented with an oral insulin pill. But oral insulin pill could delay the onset of type 1 diabetes in some children.
Researchers have conducted trials among 560 children from nine countries with an average age of eight years, who are at high risk (that is relatives with at least 2 autoantibodies including normal glucose tolerance and insulin autoantibodies) to the development of type 1 diabetes. All the participants were white, enrolled between March 2, 2007 to December 21, 2015. Sixty percent of them were male. They conducted follow up studies 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 have conducted oral glucose tolerance tests for every six months to diagnose type 1 diabetes development in them for a period of 2.7 years.
The study results show type 1 diabetes development among participants taking oral insurance was 28 percent and among participants taking the placebo was 33 percent. But five percent difference between two groups was statistically insignificant or difference was not strong enough to draw a conclusion.
But among children with low insulin secretion or production, researchers have observed 2.5 years (31 months) delay in the onset of type 1 diabetes condition with oral insulin pill medication when compared with a group of children under placebo medication.
Researchers concluded the study by saying oral insulin pills may not prevent the onset of type 1 diabetes among children. But they want to see whether the higher dosage of oral insulin pills could prevent type 1 diabetes development.
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 findings were published 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.