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Proposed interventions to prevent or delay the autoimmune response that leads to type 1 diabetes include reducing early exposure to complex antigens. In an international multicenter trial, 2159 infants at risk for type 1 diabetes (risk-conferring HLA genotype and at least 1 first-degree relative with diabetes) were randomized to be weaned to either an extensively hydrolyzed casein-based formula or conventional cow's milk–based formula for at least 60 days and up to 6 months. The investigators previously reported findings at 7 years: hydrolyzed casein formula did not prevent or delay development of islet cell autoantibodies (NEJM JW Pediatr Adolesc Med Aug 2014 and JAMA 2014; 311:2279). Now they report outcomes at 11 years.
Study formula was …