DIAGNOSIS AND THERAPY TO TYPE-1 DIABETES

The therapeutic goal normoglycemia can not realized in most children a nd adolescents suffering from typs 1 diabetes. Many of them develop mi crovascular complications later in life. There were many trials to pre vent the destruction of functioning beta-cells after onset of diabetes . All of them could not restore the insulin secretion. II is necessary to intervene at an earlier stage in the disease process and to stop t he autoimmune destruction of beta-cells. Nicotinamide, a derivative of the B-3 vitamin nicotinic acid, has been shown to prevent both chemic ally-induced and spontaneous development in animal models of typ 1 dia betes. These observations have led to clinical pilot trials in first d egree relatives at increased risk of progressing to clinical disease. To clarify the effect of oral nicotinamide in the prevention of type 1 diabetes DENIS (Deutsche Nicotinamid Interventionsstudie) - a prospec tive, randomized, placebo controlled study - was planned. This study s tarted 1993. First degree relatives (age 3-12 years) at increased risk to clinical disease (ICA greater than or equal to 20 IDF units) were offered treatment. At this time 37 children are treated. To evaluate t he preventive effect of nicotinamid 70-80 probands are needed. The ind ividual treatment lasts 5 years.