September 2026. Volume 22. Number 3

Oral insulin immunotherapy to prevent type 1 diabetes: the eternal promise

 
 
 
 
 
 
 
 
 
 
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AVC | Critically appraised articles

Ziegler AG, Achenbach P, Weiß A, Berner R, Casteels K, Elding Larsson H, et al; GPPAD-POInT Study Group. Efficacy of once-daily, high-dose, oral insulin immunotherapy in children genetically at risk for type 1 diabetes (POInT): a European, randomised, placebo-controlled, primary prevention trial. Lancet. 2025;406:2564-76.

Reviewers: Pérez Solís D1, Fraile Astorga G2.
1Servicio de Pediatría. Hospital Universitario de Cabueñes. Gijón. Asturias. España.
2Pediatra. CS Cuellar. Segovia. España.
Correspondence: David Pérez Solís. Email: david@perezsolis.es
Reception date: 07/09/2026
Acceptance date: 14/09/2026
Publication date: 23/09/2026

Abstract

Authors´ conclusions: there was no evidence that high-dose, daily oral insulin prevents the development of islet autoantibodies. Further studies are needed to assess the benefit of primary oral insulin therapy for preventing diabetes in genotype-selected infants.

Reviewers´ commentary: currently, oral insulin cannot be recommended as a treatment to delay the onset of type 1 diabetes in at-risk populations. The emergence of other promising therapies, such as teplizumab, is likely to influence the development of new clinical trials. If a subgroup of patients in whom it proves effective were identified, differences in cost and safety profile among these options would need to be assessed.

How to cite this article

Pérez Solís D, Fraile Astorga G. Inmunoterapia oral con insulina para prevenir la diabetes tipo 1: la eterna promesa. Evid Pediatr. 2026;22:30.

AVC | Critically appraised articles

Ziegler AG, Achenbach P, Weiß A, Berner R, Casteels K, Elding Larsson H, et al; GPPAD-POInT Study Group. Efficacy of once-daily, high-dose, oral insulin immunotherapy in children genetically at risk for type 1 diabetes (POInT): a European, randomised, placebo-controlled, primary prevention trial. Lancet. 2025;406:2564-76.

Reviewers: Pérez Solís D1, Fraile Astorga G2.
1Servicio de Pediatría. Hospital Universitario de Cabueñes. Gijón. Asturias. España.
2Pediatra. CS Cuellar. Segovia. España.
Correspondence: David Pérez Solís. Email: david@perezsolis.es
Reception date: 07/09/2026
Acceptance date: 14/09/2026
Publication date: 23/09/2026

How to cite this article

Pérez Solís D, Fraile Astorga G. Inmunoterapia oral con insulina para prevenir la diabetes tipo 1: la eterna promesa. Evid Pediatr. 2026;22:30.

23/09/2026

Linked Comment

Methodological note