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Erschienen in: Der Diabetologe 4/2018

17.05.2018 | Typ-1-Diabetes | Leitthema

Typ-1-Diabetes im asymptomatischen Frühstadium

Orales Insulin zur präventiven Behandlung

verfasst von: PD Dr. P. Achenbach

Erschienen in: Die Diabetologie | Ausgabe 4/2018

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Zusammenfassung

Hintergrund

Insulin ist bei Kindern, die Typ-1-Diabetes entwickeln, meist das erste Ziel der Autoimmunreaktion und gilt deshalb als aussichtsreicher Kandidat für eine antigenspezifische Immunmodulation zur präventiven Behandlung der Erkrankung.

Studienresultate

Weltweit wurden in klinischen Studien schon mehrere hundert Kinder mit oralem Insulin in verschiedenen Dosierungen behandelt, ohne dass Nebenwirkungen auftraten. In 2 großen Studien konnte insgesamt kein präventiver Effekt mit täglich 7,5 mg Insulin oral bei betazellautoantikörperpositiven Personen erzielt werden, obgleich eine verzögerte Diabetesentwicklung in Subgruppen beobachtet wurde. In einer Pilotstudie jedoch wurde mit täglich 67,5 mg Insulin oral eine regulatorische Immunantwort gegen Insulin induziert.

Laufende Studien mit hochdosiertem oralem Insulin

Der präventive Effekt von täglich 67,5 mg Insulin oral auf die Diabetesentwicklung wird gegenwärtig geprüft; bei betazellautoantikörperpositiven Kindern mit einem asymptomatischen Frühstadium des Typ-1-Diabetes (Fr1da-Insulin-Interventions-Studie) sowie bei autoantikörpernegativen Kindern mit genetischem Risiko für Typ-1-Diabetes (POInT [„primary oral insulin trial“]).
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Metadaten
Titel
Typ-1-Diabetes im asymptomatischen Frühstadium
Orales Insulin zur präventiven Behandlung
verfasst von
PD Dr. P. Achenbach
Publikationsdatum
17.05.2018
Verlag
Springer Medizin
Erschienen in
Die Diabetologie / Ausgabe 4/2018
Print ISSN: 2731-7447
Elektronische ISSN: 2731-7455
DOI
https://doi.org/10.1007/s11428-018-0341-z

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