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Predigested Formula May Prevent Diabetes in at-Risk Infants

50% Fewer Kids Fed Nutramigen Get Marker of Type 1 Diabetes in Pilot Study
By
WebMD Health News
Reviewed by Louise Chang, MD

Nov. 11, 2010 – For the first time, a study suggests that a change in diet can influence the process leading to type 1 diabetes in infants at high risk for the disease.

There's no proof that the dietary change -- using a predigested infant formula instead of normal formula when a mother stops breastfeeding -- actually prevents type 1 diabetes. 

But compared to babies fed normal formula, those who got the special formula were 50% less likely to develop the kind of antibodies that predict diabetes, reports Mikael Knip, MD, PhD, of the University of Helsinki, Finland.

Predigested formula -- also called hydrolyzed formula -- is a formula in which the protein content has been broken down into smaller proteins that can be digested more easily, according to the American Academy of Pediatrics.

The study findings apply only to infants that carry genetic factors indicating high diabetes risk, and not to children in the general population.

"My interpretation is that the dietary intervention reduces the initiation of the disease process leading to type 1 diabetes," Knip tells WebMD.

Not so fast, warn University of Massachusetts diabetes experts David M. Harlan, MD, and Mary M. Lee, MD. While they praise Knip's team for a carefully conducted study, they note that this small pilot study was far from definitive.

"It is very difficult to draw conclusions from this data," Lee, a pediatric endocrinologist, tells WebMD. "Their conclusion that there is a suggestion that the [predigested] formula might be protective is exactly that: a suggestion."

"Just by chance, those kids randomized to the [predigested] formula got that formula a little bit later. They were consuming breast milk a little bit longer, and maybe that explains it," Harlan tells WebMD. "This study adds further interest to the association between early diet and diabetes, but it is not the final answer. I don't want anybody to draw the conclusion that this formula prevents diabetes."

Sixteen of the study's 230 children went on to develop diabetes over a median follow-up period of 7.5 years. Seven of these kids were in the group scheduled to receive the predigested formula. But Knip notes that only four of them actually got the special formula.

Knip is more positive about the findings than either Harlan or Lee.

"I think that if you have a diabetic family member and have a newborn baby, the first recommendation is to breastfeed as long as possible," Knip says. "But then our recommendation is you should use a [predigested] formula. But I would not recommend this to the general population -- only to children with a first-degree relative who has type 1 diabetes."

Harlan and Lee agree with only part of this advice: That parents from families at higher risk of diabetes should breastfeed for as long as possible.

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