Nicotinamide protected first-phase insulin response (FPIR) and prevented clinical disease in first-degree relatives of type-1 diabetics

After a study of ICA prevalence among relatives of Type-1 diabetics (DM1) in Santiago, Chile, parents of those who tested positive asked us to go on forward with an intervention study. We had screened 1021 relatives, of which 30 had shown ICA ≥ 20 JDF units (2.9%). Among the 26/30 who participated i...

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Published in:	Diabetes research and clinical practice Vol. 71; no. 3; pp. 320 - 333
Main Authors:	Olmos, Pablo R., Hodgson, María I., Maiz, Alberto, Manrique, Mónica, De Valdés, Marcelo Díaz, Foncea, Rocío, Acosta, Ana M., Emmerich, Matías V., Velasco, Soledad, Muñiz, Osvaldo P., Oyarzún, Cristóbal A., Claro, Juan C., Bastías, María J., Toro, Luis A.
Format:	Journal Article
Language:	English
Published:	Ireland Elsevier Ireland Ltd 01-03-2006
Subjects:	Adolescent Adult Autoantibodies - blood Child Child, Preschool Chile Diabetes Mellitus, Type 1 - blood Diabetes Mellitus, Type 1 - immunology Diabetes Mellitus, Type 1 - prevention & control Diabetic Ketoacidosis Family Female Glucose Tolerance Test Humans Insulin - blood Insulin - metabolism Insulin Secretion Male Niacinamide - therapeutic use Nicotinamide Patient Selection Placebos Prevention Type-1 diabetes mellitus Chile Prevention Type-1 diabetes mellitus Nicotinamide
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Summary:	After a study of ICA prevalence among relatives of Type-1 diabetics (DM1) in Santiago, Chile, parents of those who tested positive asked us to go on forward with an intervention study. We had screened 1021 relatives, of which 30 had shown ICA ≥ 20 JDF units (2.9%). Among the 26/30 who participated in the intervention study, the baseline screening showed normal glucose tolerance in all, and the first-phase insulin response (FPIR) was normal in 24/26 individuals, which were randomized into Nicotinamide ( n = 12; oral Nicotinamide, 1200 mg m −2 day −1) and Placebo ( n = 12) groups. The FPIRs and ICAs were monitored yearly. Compliance was monitored by urine Nicotinamide. The 1.5, 3.0 and 5-year life-table estimates of keeping the FPIR ≥ 10th centile were, for Nicotinamide group 100% in all time points, and for Placebo these were 90.0% (c.i. = 100–71.4), 72.0% (c.i. = 100–37.1) and 0.0% (c.i. = 0.0–0.0) ( p = 0.0091). The 5-year life-table estimates of remaining diabetes-free were 100% for Nicotinamide and 62.5% for Placebo ( p = 0.0483). No adverse effects were observed. Oral Nicotinamide protected beta-cell function and prevented clinical disease in ICA-positive first-degree relatives of type-1 diabetes.
Bibliography:	ObjectType-Article-2 SourceType-Scholarly Journals-1 ObjectType-News-1 ObjectType-Feature-3 content type line 23
ISSN:	0168-8227 1872-8227
DOI:	10.1016/j.diabres.2005.07.009