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NEJM
30 May 2002
Parenteral
Insulin in Relatives of Patients with Type 1 Diabetes Mellitus
Persons who are at high risk for type 1 diabetes may be identified
on the basis of islet-cell antibody levels, insulin antibody levels,
and genetic studies. These investigators randomly assigned 339
high-risk first- and second-degree relatives of patients with
diabetes (mean age, 11.2 years) either to observation or to
low-dose subcutaneous ultralente insulin twice daily, plus an
annual four-day continuous intravenous infusion of insulin. By
the end of the study, diabetes had been diagnosed in 69 subjects in
the intervention group and 70 in the observation group, an annualized
rate of progression of 15.1 percent in the intervention group
and 14.6 percent in the observation group.
Insulin in the dose
and regimen used in this study neither delayed nor prevented
type 1 diabetes in high-risk persons.
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