Type 1 Diabetes
Conditions
Keywords
diabetes, juvenile diabetes, insulin deficiency
Brief summary
Children born in Turku, Oulu and Tampere university cities in Finland are screened at birth for HLA alleles that carry increased risk to or protection from development of type 1 diabetes. Children carrying increased risk are followed at 3-12-month intervals for development of diabetes-associated autoantibodies. Children having at least two types of autoantibodies (of the four measured) in at least two consecutively drawn samples are randomized to receive daily intranasal insulin or placebo in a double-blinded 1:1 trial. Hypothesis is that intranasal insulin delays or prevents development of clinical type 1 diabetes. The primary outcome measure is development of clinical diabetes.
Detailed description
Children born in Turku, Oulu and Tampere university cities in Finland are screened at birth for the HLA-DQB1 and DQA1 alleles that carry increased risk to or protection from development of type 1 diabetes. Children carrying increased risk are followed at 3-month intervals until 2 years of age and then at 6-12-month intervals until,15 years of age for development of diabetes-associated autoantibodies (autoantibodies against islet cells, insulin, glutamic acid decarboxylase and IA-2 protein). Children having at least two types of autoantibodies of the four measured in at least two consecutively drawn samples are randomized to receive daily intranasal insulin or placebo in a double-blinded 1:1 trial. Hypothesis is that intranasal insulin delays or prevents development of clinical type 1 diabetes. The primary outcome measure is development of clinical diabetes, but serum concentrations of autoantibodies, responses to intravenous glucose tolerance test and possible side effects of therapy are also closely monitored.
Interventions
Sponsors
Study design
Eligibility
Inclusion criteria
* children carrying HLA-conferred genetic risk for developing type 1 diabetes * have had at least two types of autoantibodies of ICA, IAA, GADA and IA-2A in at least two consecutive blood samples drawn at least 3 months apart * age at least one year
Exclusion criteria
* severe other disease * age above 15 years
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Development of clinical type 1 diabetes | — |
Secondary
| Measure | Time frame |
|---|---|
| Number and concentration in serum of diabetes-associated autoantibodies (ICA, IAA, GADA and IA-2A) | — |
| Responses to intravenous glucose tolerance test | — |
| Possible side effects of therapy including hypoglycemia | — |
| Changes in serum metabolite patterns (metabolomics) | — |
Countries
Finland