A Two Year Observational Study of Nicotinamide and Intensive Insulin Therapy in Patients with Recent Onset Type I Diabetes Mellitus

Abstract

Implementation of IIT with the addition of nicotinamide at diagnosis continued for 2 years improves metabolic control as assessed by HbA1c. In both nicotinamide and control patients, no decline in C-peptide was detected 2 years after diagnosis, indicating that IIT preserves C-peptide secretion. We conclude that nicotinamide + IIT at diagnosis of DM1 prolonged for up to 2 years can be recommended, but longer follow-up is required to determine whether nicotinamide should be continued beyond this period.

“SLY AS A FOXO”: New Paths with Forkhead Signaling in the Brain

“…Oral nicotinamide (1200mg/m 2 / day) protects -cell function and prevents clinical disease in isletcell antibody-positive first-degree relatives of type-1 diabetes (Olmos et al, 2005). In addition, treatment with nicotinamide (25mg/kg) in patients with recent onset type-1 diabetes mellitus combined with intensive insulin therapy for up to two years after diagnosis can reduce HbA 1c levels (Crino et al, 2005). Potentially relevant to diabetic patients with renal failure, nicotinamide also has been shown to reduce intestinal absorption of phosphate and prevent the development of hyperphosphatemia and progressive renal dysfunction (Eto et al, 2005).…”

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“…There was no difference in insulin requirement and c-peptide levels at 2 years after diagnosis; however, HbA 1c was noted to be lower in the nicotinamide group. 15 These findings suggest that c-peptide secretion is similarly preserved in children treated solely with insulin, and the reduction in HbA 1c warrants further research.…”

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“…Oral application of nicotinamide can also protect β-cell function and prevents clinical disease in islet-cell antibody-positive first-degree relatives of Type 1 DM [18]. In addition, treatment with nicotinamide in patients with recent-onset Type-1 DM combined with intensive insulin therapy for up to 2 years after diagnosis significantly levels [19]. Potentially relevant to diabetic patients reduced HbA 1c with renal failure, nicotinamide has also been shown to reduce intestinal absorption of phosphate and prevent the development of hyperphosphatemia and progressive renal dysfunction.…”