Oral Insulin Therapy to Prevent Progression of Immune-Mediated (Type 1) Diabetes
| العنوان: | Oral Insulin Therapy to Prevent Progression of Immune-Mediated (Type 1) Diabetes |
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| المؤلفون: | Berrin Ergun-Longmire, Philip Raskin, John I. Malone, Noel K. Maclaren, Desmond A. Schatz, Sherwyn Schwartz, Jeffrey P. Krischer, Adina Zeidler, Robert Rapaport, Douglas Rogers, John Marker, Alfonso Vargas, Bruce W. Bode |
| المصدر: | Annals of the New York Academy of Sciences. 1029:260-277 |
| بيانات النشر: | Wiley, 2004. |
| سنة النشر: | 2004 |
| مصطلحات موضوعية: | medicine.medical_specialty, Time Factors, medicine.medical_treatment, Administration, Oral, Endogeny, General Biochemistry, Genetics and Molecular Biology, Placebos, Immune system, History and Philosophy of Science, Diabetes mellitus, Internal medicine, Humans, Hypoglycemic Agents, Insulin, Medicine, Ingestion, In patient, Adverse effect, Autoantibodies, Glycated Hemoglobin, Type 1 diabetes, C-Peptide, Dose-Response Relationship, Drug, business.industry, General Neuroscience, Drug Tolerance, medicine.disease, Diabetes Mellitus, Type 1, Endocrinology, Disease Progression, business, Follow-Up Studies |
| الوصف: | Repeated ingestion of insulin has been suggested as an immune tolerization therapy to prevent immune-mediated (type 1) diabetes. We performed a placebo-controlled, two-dose, oral insulin tolerance trial in newly diagnosed (< 2 years) diabetic patients who had required insulin replacement for less than 4 weeks and were found to have cytoplasmic islet cell autoantibodies (ICAs). No oral hypoglycemic agents were permitted during the trial. Endogenous insulin reserves were estimated at six-month intervals by plasma C-peptide responses to a mixed meal. Positive ICAs were found in 262 (31%) of the 846 patients screened. Of the 197 who agreed to participate, 187 could be followed for 6 to 36 months. Endogenous insulin retention was dependent upon initial stimulated C-peptide response, age at diabetes onset, and numbers of specific islet cell autoantibodies found. Oral insulin improved plasma C-peptide responses in patients diagnosed at ages greater than 20 years, best seen at the low (1 mg/day) over the high (10 mg/day) insulin dose (P = .003 and P = .01, respectively). In patients diagnosed before age 20 years, the 1 mg dose was ineffective, whereas the 10 mg dose actually accelerated C-peptide loss (P = .003). There were no adverse effects. If confirmed, these findings suggest that diabetic patients over age 20 years with ICA evidence of late-onset immune-mediated diabetes should be considered for oral insulin at 1 mg/day to better retain endogenous insulin secretion. |
| تدمد: | 1749-6632 0077-8923 |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::34aea2c673d995d11b9e92ae94a2eb1f https://doi.org/10.1196/annals.1309.057 |
| حقوق: | CLOSED |
| رقم الأكسشن: | edsair.doi.dedup.....34aea2c673d995d11b9e92ae94a2eb1f |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 17496632 00778923 |
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