Combination of nicotinamide and steroid versus nicotinamide in recent-onset IDDM. The IMDIAB II Study

• Published in: Diabetes care Vol. 17; no. 8; pp. 897 - 900
• Main Authors: Pozzilli, P, Visalli, N, Boccuni, M L, Baroni, M G, Buzzetti, R, Fioriti, E, Signore, A, Cavallo, M G, Andreani, D, Lucentini, L
• Format: Journal Article
• Language: English
• Published: United States American Diabetes Association 01.08.1994
• Subjects: Adolescent; Adult; Age Factors; Anti-Inflammatory Agents - therapeutic use; C-Peptide - blood; Child; Child, Preschool; Diabetes Mellitus, Type 1 - blood; Diabetes Mellitus, Type 1 - drug therapy; Drug Therapy, Combination; Female; Follow-Up Studies; Glucagon; Glycated Hemoglobin A - metabolism; Humans; Insulin - therapeutic use; Male; Niacinamide - therapeutic use; Pregnenediones - therapeutic use
• ISSN: 0149-5992; 1935-5548
• DOI: 10.2337/diacare.17.8.897

Combination of nicotinamide and steroid versus nicotinamide in recent-onset IDDM. The IMDIAB II Study. P Pozzilli , N Visalli , M L Boccuni , M G Baroni , R Buzzetti , E Fioriti , A Signore , M G Cavallo , D Andreani and L Lucentini Istituto di Clinica Medica II, Universita di Roma La Sapienza, Italy. Abstract OBJECTIVE--The aim of this study was to compare the effect of nicotinamide (NCT) alone or in combination with a cortisone-like substance, deflazacort (DFL), on the integrated parameters of metabolic control in patients with the recent-onset of insulin-dependent diabetes mellitus (IDDM). RESEARCH DESIGN AND METHODS--Thirty-six patients who were diagnosed with diabetes between 5 and 35 years of age entered a randomized, double-blind, 1-year prospective study. Group A (n = 18) received NCT for 1 year (25 mg.kg-1.day-1) plus DFL for 3 months (0.6 mg.kg-1.day-1 in the first month, 0.3 mg.kg-1.day-1 in the other 2 months). Group B (n = 18) received NCT for 1 year (25 mg.kg-1.day-1) plus placebo for the first 3 months. All patients were treated with intensified insulin therapy. RESULTS--At 3 months after diagnosis, the insulin dose was significantly higher in group A compared with group B (P < 0.03) with similar HbA1 levels. Basal and stimulated C-peptide levels in group A of both adults and children were significantly higher compared with patients of group B (P < 0.05 and P < 0.03, respectively). At the end of a 1-year follow-up, basal C-peptide did not differ between the two groups, although stimulated C-peptide was still significantly higher in patients of group A compared with group B (P < 0.05). Finally, insulin requirement did not differ between the two groups. CONCLUSIONS--A short-term course of DFL therapy at diagnosis in addition to NCT slightly increases glucagon-stimulated but not basal beta-cell function after 1 year.