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Could 'oral insulin' prevent type 1?

17 October 2012

Researchers in Denmark are beginning a new clinical trial to test if insulin capsules could prevent the development of type 1 in some people who are at risk.

A previous study in America and Canada tested 'oral insulin' in people who had two or more autoantibodies indicating they had an increased risk of developing type 1. One of these autoantibodies had to be against insulin. Initially the trial results were disappointing, as taking the insulin orally did not appear to protect against type 1.

Autoantibodies are signs that the immune system is preparing to fight against some parts of the body. Specific autoantibodies have been identified that increase a person’s risk of developing type 1.

Following the initial analysis of the trial data, another more detailed analysis of the study data found that people with high levels of the insulin antibody were protected from the development of type 1. The analysis highlighted that if a person with high levels of insulin autoantibodies took the insulin capsules, they were less likely to develop type 1 than a person with similar levels of insulin autoantibodies who took the inactive placebo. This affect appeared to last for as long as the participants took the oral insulin.

Based on these results, Dr Ake Lernmark is about to begin a new trial that will test oral insulin in people who do not have type 1 but do have high levels of insulin autoantibodies.

Maebh Kelly, Research Communication Officer at JDRF, said: ‘The reasons why oral insulin might protect against the development of type 1 are still unclear. It is possible that the immune system builds up a tolerance to low daily doses of insulin and eventually stops identifying it as a threat.'

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