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[IP] Insulin Fails Test As Preventive


Insulin Fails Test As Preventive *
/Wed May 29, 5:00 PM ET/

/By JEFF DONN, Associated Press Writer/

BOSTON (AP) - To doctors' disappointment, a landmark study has found
that preventive injections of insulin do not ward off a common form of

The idea of preventing diabetes with insulin has been considered for
decades. More recently, animal research and small studies with people
suggested it would work for type 1 diabetes. Some doctors were already
giving insulin to patients in the hope of preventing it.

"The history of medicine is littered with wrong conclusions drawn from
pilot studies," said Dr. Jay Skyler, a hormone specialist at the
University of Miami who led the study, which was funded by the National
Institutes of Health (news
- web sites

The preliminary findings were reported in Thursday's New England Journal
of Medicine (news
- web sites

Up to 1 million Americans have the disease, formerly known as juvenile
diabetes, and face a lifetime of taking insulin. The body's defenses
attack the pancreas' ability to make insulin, a substance that processes
sugar. People at high risk for type 1 diabetes can be identified from
antibodies and other testing.

In theory, preventive insulin could either rest the body's insulin cells
and thus make them stronger, or retool the immune system to stop its
assault on the pancreas.

More common type 2 diabetes -- in which the body cannot process insulin
correctly -- would be beyond the reach of preventive insulin.

Of 84,228 screened for the study, 339 were identified with a five-year
risk of more than 50 percent of developing diabetes. They were randomly
assigned to undergo insulin injections or just monitoring. Both groups
developed the disease at an annual rate of about 15 percent.

The research team is still working on preventing type 1 diabetes with an
insulin pill, which is thought to work by a different mechanism. Those
findings could come next year.

Dr. Richard Jackson, a study supervisor at Boston's Joslin Diabetes
Center, said he holds "reasonable hope" for success with the pill. "If
we look at the history of clinical research, it's rare that the first
arrow hits the target," he said.

A separate study in the journal did offer some hope for people with the
type 1 disease.

The researchers found that a drug designed from an immune-system
antibody known as OKT3 can arrest the disease in its early stages for at
least a year. However, the drug is not expected to delay the disease

Twelve patients were treated in this preliminary test supervised at
Columbia University. Nine kept their ability to make insulin.
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