From Maine, USA:
I have a 15 year old son that is participating in the DPT-1 trials. He is in the upper arm of the study. He may start taking insulin within the next month. Once he starts taking insulin will he ever be able to stop? Also will the insulin tell the pancreas to stop producing insulin altogether?
At the present time the plan is to recruit additional antibody positive family members into the trial for three more years. It looks however as though this phase may have to on a little longer in order to have enough young people in the study. For those already in DPT-1 as controls or taking insulin the objective is to continue for seven years. During and at the end of that time there are several possibilities:
- Your son may develop conventional clinical diabetes and have to continue insulin for the rest of his life or until transplants for young people become more reliably successful. All the evidence, however, is that giving insulin at any time spares the supply from the islets so that your son's own insulin will last longer and will not be suppressed.
- If your son had not yet developed clinical diabetes and did not require the increased dose of insulin, he could continue with the small dose with the expectation that the onset of common long term complications would also be delayed.
- He could switch to some other form of prevention, if by that time, it had been shown to be more successful in delaying clinical diabetes than small doses of insulin by injection. Such possibilities might include oral insulin or 'vaccination' with a segment of the B chain of insulin.
- Depending on the levels of antibodies and the amount of first phase insulin release, i.e., the serum insulin level after a glucose load, he might elect just to discontinue insulin and of course he can elect to do this at any time.
Original posting 2 Dec 96
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