title: Vitamin E and nicotinamide have similar effects in maintaining residual beta cell function in recent onset insulin-dependent diabetes (the IMDIAB IV study)
abstract: OBJECTIVE
  Protection of residual beta cell function at the time of diagnosis of insulin-dependent diabetes mellitus (IDDM) by intensive insulin therapy and the addition of nicotinamide (NA) has been established. The objective of this study was to evaluate the effect of a free oxygen radical scavenger such as vitamin E (Vit E) on residual beta cell function and parameters of metabolic control in patients with recent onset IDDM undergoing intensive insulin therapy.
  
  
  METHODS
  The effect of Vit E was compared with that of NA (control group) in a randomized multicentre trial.
  
  
  METHODS
  Eighty-four IDDM patients between 5 and 35 years of age (mean age 15.8 +/- 8.4 (s.d.) years) entered a one year prospective study. One group of patients (n = 42) was treated with Vit E (15 mg/kg body weight/day) for one year; the other group (n = 42) received NA for one year (25 mg/kg body weight/day). All patients were under intensive insulin therapy with three to four injections a day. Basal and stimulated (1 mg i.v. glucagon) C-peptide secretion, glycosylated haemoglobin and insulin dose were evaluated at diagnosis and at three-monthly intervals up to one year.
  
  
  RESULTS
  Preservation and slight increase of C-peptide levels at one year compared with diagnosis were obtained in the two treated patient groups. No statistically significant differences were observed in basal or stimulated C-peptide levels between the two groups of patients for up to one year after diagnosis. Glycosylated haemoglobin and insulin dose were also similar between the two groups; however patients receiving Vit E under the age of 15 years required significantly more insulin than NA-treated patients one year after diagnosis (P < 0.04).
  
  
  CONCLUSIONS
  Our data indicate that Vit E and NA possess similar effects in protecting residual beta cell function in patients with recent onset IDDM. Since their putative mechanism of protection on beta cell cytotoxicity is different, combination of these two vitamins may be envisaged for future trials of intervention at IDDM onset.
authors.affiliation: Department of Diabetes and Metabolism, St Bartholomew's Hospital Medical College, London, UK.
authors.forename: P
authors.initials: P
authors.lastname: Pozzilli
authors.forename: N
authors.initials: N
authors.lastname: Visalli
authors.forename: M G
authors.initials: MG
authors.lastname: Cavallo
authors.forename: A
authors.initials: A
authors.lastname: Signore
authors.forename: M G
authors.initials: MG
authors.lastname: Baroni
authors.forename: R
authors.initials: R
authors.lastname: Buzzetti
authors.forename: E
authors.initials: E
authors.lastname: Fioriti
authors.forename: C
authors.initials: C
authors.lastname: Mesturino
authors.forename: R
authors.initials: R
authors.lastname: Fiori
authors.forename: A
authors.initials: A
authors.lastname: Romiti
authors.forename: C
authors.initials: C
authors.lastname: Giovannini
authors.forename: L
authors.initials: L
authors.lastname: Lucentini
authors.forename: M C
authors.initials: MC
authors.lastname: Matteoli
authors.forename: A
authors.initials: A
authors.lastname: Crinò
authors.forename: C
authors.initials: C
authors.lastname: Teodonio
authors.forename: F
authors.initials: F
authors.lastname: Paci
authors.forename: R
authors.initials: R
authors.lastname: Amoretti
authors.forename: L
authors.initials: L
authors.lastname: Pisano
authors.forename: C
authors.initials: C
authors.lastname: Suraci
authors.forename: G
authors.initials: G
authors.lastname: Multari
authors.forename: M
authors.initials: M
authors.lastname: Suppa
authors.forename: N
authors.initials: N
authors.lastname: Sulli
authors.forename: G
authors.initials: G
authors.lastname: De Mattia
authors.forename: M R
authors.initials: MR
authors.lastname: Faldetta
authors.forename: M T
authors.initials: MT
authors.lastname: Suraci
mesh_terms: D000293:Adolescent; D000328:Adult; D002096:C-Peptide / Q000097:blood; D002648:Child; D002675:Child, Preschool; D003922:Diabetes Mellitus, Type 1 / Q000188:drug therapy* / Q000503:physiopathology*; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D007328:Insulin / Q000008:administration & dosage / Q000627:therapeutic use; D007515:Islets of Langerhans / Q000503:physiopathology*; D007970:Leukopenia / Q000139:chemically induced; D009536:Niacinamide / Q000627:therapeutic use*; D011446:Prospective Studies; D014810:Vitamin E / Q000009:adverse effects / Q000627:therapeutic use*
chemical_list: D002096:C-Peptide; D006442:Glycated Hemoglobin; D007328:Insulin; D009536:Niacinamide; D014810:Vitamin E