Can Oral Insulin Slow Onset of Type 1 Diabetes in High-Risk Patients?

In an earlier study, oral insulin did not prevent or delay onset of type 1 diabetes in close relatives of type 1 diabetics, but subgroup analysis suggested a possible benefit in those with higher autoantibody titers (Diabetes Care 2005; 28:1068). To explore this issue, researchers studied 560 nondiabetic first- and second-degree relatives (age range, 3–45 years) of patients with type 1 diabetes. Participants were assessed for diabetes autoantibodies and first-phase insulin release, were sorted into various subgroups, and were randomized to oral insulin (7.5 mg daily) or placebo. The study focused on a subgroup of 389 participants with higher first-phase insulin release.

During median follow-up of 2.7 years, annualized rates of type 1 diabete…