Autoimmune processes are involved in pancreatic beta-cell destruction in type 1 diabetes... Generation of free radicals, DNA strand breaks, activation of the enzyme poly (ADP-ribose) polymerase (PARP), and depletion of intracellular nicotinamide adenine dinucleotide (NAD) appear to be common factors in beta-cell death, whether mediated by oxygen radicals, nitric oxide, or streptozotocin.

Nicotinamide, a soluble B group vitamin which offers protection against these toxic stimuli, is at high doses a free radical scavenger, a potent inhibitor of PARP, and protects against depletion of intracellular NAD. A sound scientific rationale therefore exists for its use in human prediabetes, and promising pilot studies have been performed in ICA-positive first-degree relatives and school children.

No serious side effects have been reported from its use at the doses proposed in man or other species.

About the Authors

Gale EA. (1996). Molecular Mechanisms of Beta-cell Destruction in Iddm: the Role of Nicotinamide. Horm Res 1996;45 Suppl 1:39-43. Department of Diabetes and Metabolism, St Bartholomew's Hospital, London, UK.