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Beta cell function can be preserved in patients with type 1 diabetes for at least two years after diagnosis by adding nicotinamide (NA) therapy to intensive insulin therapy (IIT). That, according to a study presented at EASD.
The researchers measured C-peptide values (an indicator of residual beta cell function) in 35 patients (mean age 15.6 years, age range 5-35 years) with recent-onset (less than four weeks) type 1 diabetes every three months for a period of two years.
All patients received biweekly NA therapy (25mg/kg), in addition to IIT (3 injections of regular insulin at meals, plus one NPH insulin at bedtime) from the time of diagnosis. The insulin dose and HbA1c levels were also recorded every 3 months.
The results showed that all patients were well controlled metabolically, with mean HbA1c levels of 6.2 percent ± 1.2 SD. The mean insulin dose required to achieve this value was 0.58 IU ± 0.31SD. No adverse reactions to NA were observed in any of the patients during the course of the trial.
Mean C-peptide values at the end of the trial were 0.76 ng/mL ± 0.79 SD–up from 0.68 ng/mL at the time of diagnosis (a mean increase of 11.7 percent). This represents a major improvement, when compared to historical data obtained from over 500 control patients, the researchers noted. The historical data show that C-peptide levels in the control patients (who received IIT alone) usually fell below 0.5 ng/mL two years after diagnosis.
Based on these results, the researchers concluded that combined therapy with NA and IIT can preserve beta cell function for at least two years after diagnosis of type 1 diabetes.
Maintenance of beta cell function in type 1 diabetes is associated with a reduced frequency of late diabetic complications, said Dr. Paolo Pozzilli, of the University of Rome, Italy, one of the co-authors of the study. Therefore, in order to protect beta cell function, the researchers recommend the implementation of NA therapy, in addition to IIT, in patients with newly diagnosed type 1 diabetes.
The research was funded by the Italian Ministry of Health and the International Center for the Study of Diabetes in Rome, Italy.