PREVENTION OF INSULIN-DEPENDENT DIABETES-MELLITUS - AN OVERVIEW OF 3 TRIALS

Genetic, immune, and metabolic testing can reveal a person's risk of d eveloping insulin-dependent diabetes mellitus (IDDM), and three large clinical trials are planned or underway to see if interventions can pr event IDDM in persons at risk. KEY POINTS Researchers in diabetes prev ention trials are screening first- and second-degree relatives of prob ands with IDDM for islet-cell antibodies. In the Cow's Milk Avoidance Trial, infant siblings of probands with IDDM will be randomized to rec eive either a baby formula containing a non-antigenic protein hydrolyz ate or a standard cow's milk-based formula. The Diabetes Prevention Tr ial-Type I is randomly assigning subjects at high risk (more than a 50 % probability of developing IDDM) to either receive insulin injections or undergo observation alone; subjects at intermediate risk (25% to 5 0%) will receive either oral insulin or placebo. In the European Nicot inamide Diabetes Intervention Trial, subjects receive either nicotinam ide or placebo. If any of these trials show that IDDM can be prevented , then large-scale screening of children for IDDM risk factors may pro ve beneficial.