Insulin shots fail to prevent diabetes.

Physicians can identify children or young adults who are likely to develop type I, or juvenile-onset, diabetes. These people have a relative with the disease, and their blood carries a telltale antibody against islet cells in the pancreas. These cells produce insulin, the hormone needed to metabolize sugars. The presence of the antibody signals that the immune system may be primed to attack the islet cells.

Tests in animals and in small groups of people have suggested that giving insulin to those who are diabetes-prone might forestall the development of type I diabetes. Although such preemptive tactics are tantalizing, a study by researchers at the University of Miami Medical School suggests they just don't work.

Physician Jay S. Skyler and his colleagues identified 339 such diabetes candidates, average age 11. Half of them received daily insulin injections; the rest did not. After 5 years, about three-fifths of people in both groups had developed diabetes. Skyler described the work at a meeting of the American Diabetes Association in Philadelphia late last month.

Prior research had suggested that insulin injections allow islet cells to rest and might make them less prone to attack by the immune system. Researchers had hoped that this would enable the insulin-producing cells to function longer, says Skyler.