Insulin does not seem to delay or prevent type 1 diabetes in those who are at high risk for developing it, suggests results from the Diabetes Prevention Trial-Type One Diabetes Study Group.
The randomised, controlled, non-blinded clinical trial was aimed at curbing onset of overt diabetes in relatives of patients with the disease. At least in the dose and regimen given in this study, however, insulin neither delayed nor prevented disease in this high risk population.
The outcome of this large North American study is in stark contrast to findings of smaller pilot studies that preceded it. During this current study, a number of subjects, of their own accord or influenced by their doctors, declined to undergo randomisation; they believed pilot studies had already answered the question of efficacy of prophylactic insulin and that this trial was merely confirmatory.
Well-designed, randomized, controlled clinical trials are clearly crucial before the issuing of guidelines for clinical practice or the implementation of public health practices, these authors underline.
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