Can infant formula prevent type 1 diabetes?
November 10th, 2010
05:33 PM ET

Can infant formula prevent type 1 diabetes?

A new study published in the New England Journal of Medicine may offer clues in reducing the number of people with type 1 diabetes.

Finnish researchers found that infants weaned to a formula that was hydrolyzed and casein-based were less likely to have indications of developing type 1 diabetes than those who received cow's milk. Casein is a milk protein. "Hydrolyzed" means the milk has gone through a process to break down large proteins, said study author Dr. Mikael Knip of the University of Helsinki.

The study participants were 230 infants who had at least one family member with type 1 diabetes and an additional genetic predisposition based on cord blood at birth. The children were randomly assigned to groups in the study. One group of children received Nutramigen, a hydrolyzed formula based on casein. The other group of children took a formula specifically tailored to the study: 80 percent intact milk protein (Enfamil formula) and 20 percent hydrolyzed milk protein. Mothers were encouraged to nonetheless continue breastfeeding their children as normal, and use the assigned formula when breast milk was not available.

Researchers followed the children up to age 10 to see if they had autoantibodies predictive of diabetes, or had progressed to develop type 1 diabetes. They found that children who had taken the Nutramigen as infants had about a 50 percent decreased risk of the autoantibodies that are predictive of diabetes.

These results are just preliminary, however, Knip said. The study did not conclude that using the Nutramigen formula instead of cow's milk truly reduces the likelihood of developing type 1 diabetes. The sample size is relatively small. It also only looked at children with a genetic predisposition to the disease. Additionally, it did not strictly compare formula or cow's milk against breastfeeding.

But it is part of a larger-scale trial called TRIGR to answer that question. There are more than 2,100 children participating in this initiative, which began in 2002. More results are expected to be released in 2013 and in 2017, Knip said. The objective is to prevent the process by which type 1 diabetes develops, he said.

Scientists do not know how the hydrolyzed casein-based formula would prevent diabetes, but one thought is that the formula has a good effect on the gut's microflora, Knip said. A separate study showed that a hydrolyzed formula can decrease gut permeability, which has to do with immune function, he said.

Despite the study's limitations, Knip said he would still recommend that when breast milk is not available, mothers of infants at elevated risk for type 1 diabetes should feed their children hydrolyzed formula.

More than 150,000 Americans under age 20 have type 1 diabetes, according to the Centers for Disease Control and Prevention. In this condition, the pancreas does not produce insulin or makes too little of it. There is no known cure.

It's different from type 2 diabetes, which happens when the body stops using insulin properly. Risk factors include an overweight and sedentary lifestyle.

Evaluate Your Diabetes Management

Mead Johnson Nutrition, the makers of Nutramigen, provided the formula for the study but did not otherwise contribute financially, Knip said. Here's an exploration of company-funded research in general.

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Get a behind-the-scenes look at the latest stories from CNN Chief Medical Correspondent, Dr. Sanjay Gupta, Senior Medical Correspondent Elizabeth Cohen and the CNN Medical Unit producers. They'll share news and views on health and medical trends - info that will help you take better care of yourself and the people you love.

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