Type 1 diabetes is no fun for anyone, and it's especially problematic because it most often afflicts the young, who then must endure a lifetime of management strategies, all too often unsuccessful and increasingly onerous. So if you're a parent of one child with type 1 diabetes, you'd unquestionably like to avoid the disease in subsequent children, known to be at risk. Now, as Rick and I discuss on PodMed this week, that may be possible by actually using insulin as an immunogenic agent. That's as reported in JAMA. Wow! we say. What a novel and unique approach to the problem, for which we offer kudos.
Researchers identified 25 children who were at risk to develop type 1 diabetes based on family history and genotype, who were randomized to oral insulin of varying doses or not over a 3 to 18 month period. Children were followed up to assess their immune response to insulin exposure with an eye toward inducing tolerance. More profound T-cell responses were seen with the highest dose of insulin, and no hypoglycemia events occurred. The investigators are moving forward into a phase 3 trial, so good news potentially for children at risk.
Other topics this week include another in JAMA, autism and vaccination (!). One from NEJM- sequelae of Ebola virus infection, and in Neurology, guidelines on the management of first time seizure in adults. Until next week, y'all live well.