Insulin to Protect

iStock_000012940072_LargeType 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.


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