ENDIT

What was ENDIT? ENDIT stands for the European Diabetes Intervention Trial. The study tested whether nicotinamide could be of use in preventing or delaying the onset of diabetes in relatives of people with type 1 diabetes. Nicotinamide is a B group vitamin and preliminary studies had shown that it may be possible to give high doses and protect against pancreatic beta cell destruction.

In the event, nicotinamide proved ineffective in the prevention of type 1 diabetes. The proportion of relatives who developed diabetes within five years was virtually identical in those treated with nicotinamide and those on placebo.

However the study did demonstrate that it is posible to do large clinical trials of this type well and gave a better understanding of disease progression. There are many potentially exciting new interventions worth exploring and ruling out nicotinamde has paved the way for this research to go forward.

To find out more read the ENDIT Results Paper (PDF, 104kB).

DPT-1

The Diabetes Prevention Trial - Type 1 was a large study run in the USA. The aim was to see if insulin given before the onset of diabetes could prevent or delay it in people at risk.

People at high risk were given low doses of injected insulin and people at moderate risk were given oral insulin. Neither of these interventions proved to be effective, although a subgroup of participants in the oral insulin study appeared to have onset of diabetes delayed slightly.

This study will be built upon in a planned TrialNet study which aims to see if this obvservation is a real effect of oral insulin in a particular subset of at risk people.

To find out more read the articles in The New England Journal of Medicine (PDF, 179kB) and Diabetes Care (PDF, 187kB).

Other Ongoing Studies

DIPP - Finland

There is a high incidence of Type 1 diabetes in Finland. The Diabetes Prediction andPrevention Trial tests all new born babies at participating hospitals for risk of getting diabetes. Those at high risk are entered into DIPP, and randomised placebo contolled trial to assess the efficacy of intranasal insulin in preventing or delaying the onset of type 1 diabetes.

To find out more visit the website of DIPP.

INIT II - Australia

Australian researchers are also looking at administration of intranasal insulin. They are looking at relatives of people with type 1 diabetes who have autoantibodies related to risk of getting diabetes. Intranasal insulin or placebo will be administered.

TRIGR

The Trial to Reduce IDDM in the Genetically at Risk Observational studies in the 1980's have shown that breastfeeding was associated with lower rates of children developing type 1 diabetes. Decreased rates of type 1 diabetes development have been found in animals weaned to hydrolyzed proteins instead of intact foreign proteins. Some evidence is now available suggesting that a similar relationship may exist in humans, but further research is needed.

The TRIGR trial will determine whether delayed exposure to intact food proteins will reduce the chances of developing type 1 diabetes later in life. All babies in the study receive the recommendation to breastfeed for at least the first six months of life. If a mother chooses to supplement with formula or wean to formula before the baby is 8 months of age, her child will be randomly assigned to one of two groups. One group will receive a trial formula based on extensively hydrolyzed protein; the other group will receive a trial formula containing a smaller amount of hydrolyzed protein.