Preventing Diabetes

Nicotinamide has been proposed as a useful therapeutic agent for the prevention of type 1 diabetes and also as an adjunct to intensive insulin therapy (Pocoit et al 1996). Interestingly, nicotinamide has also been shown to cause insulin resistance resulting in increased insulin secretion in healthy subjects with a family history of type 1 diabetes (Greenbaum et al 1996). A concern therefore exists that monitoring such people for signs of development of the disease may be complicated by the use of nicotinamide. © 2007 Elsevier Australia

Protects beta-cells Type 1 diabetes is characterised by progressive beta-cell destruction, which leads to complete insulin deficiency; at the time of diagnosis 80-90% of beta cells have been destroyed (Virtanen & Aro 1994). Nicotinamide has been shown to protect beta-cells from inflammatory insults and to improve residual beta-cell function in patients after onset of type 1 diabetes (Gale 1996, Lampeter et al

One RCT using 25 mg/kg versus 50 mg/kg nicotinamide in early onset type 1 diabetes (<4 weeks) found that both doses were likely to be effective in reducing beta-cell dysfunction. As a higher dose may cause insulin resistance, the lower dose is probably preferable (Visalli et al 1999).

Alternatively, another RCT that used slow-release nicotinamide failed to detect a reduction in diabetes incidence after 3 years (Lampeter et al 1998).

Diabetes Sustenance

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