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Researchers Investigate Oral Insulin Crystals for Type 1 Diabetes

Disease delayed in persons with high levels of insulin autoantibodies (Sept. 19)

According to a September 19 announcement from Lund University in Sweden, there are indications that a daily capsule of insulin crystals could stop the development of type 1 diabetes.

In the international TrialNet study, which follows relatives of individuals with type 1 diabetes, researchers are investigating whether oral insulin could prevent or delay the disease.

Type 1 diabetes is the autoimmune form of diabetes in which the patients’ insulin-producing beta cells are destroyed by the body’s immune system.

In a study published earlier this year, American and Canadian researchers followed participants with relatives who had type 1diabetes and at least two autoantibodies, one of them against insulin. The participants took either oral insulin or placebo capsules. At first, the results were disappointing. Just as many people in the treatment group became ill as in the placebo group.

“However, the subsequent analyses showed something different,” says Swedish researcher Åke Lernmark. “Among those who had high levels of insulin autoantibodies at the start of the study, the oral insulin had an effect, and the development of type 1 diabetes was delayed. The delaying effect lasted for as long as the participants took the insulin.”

Lernmark adds that those who are being recruited for the Swedish TrialNet study also have high levels of autoantibodies against insulin.

No one knows how oral insulin might stop type 1 diabetes. However, Lernmark believes a possible explanation could be that the immune system becomes accustomed to the low daily doses of insulin in the gastrointestinal tract. The insulin is not perceived as a foreign substance to be rejected by the immune system.

This line of reasoning is the same as for desensitization for allergies, in which the dose of the substance that provokes the allergy is gradually increased.

The TrialNet study will run for several years and is open to participants between 3 and 45 years of age.

For more information, visit the Lund University Web site.

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