Prevention of type 1 diabetes

Abstract

Introduction/background: Type 1 diabetes is a chronic autoimmune condition characterized by destruction of insulin-producing β cells within the pancreatic islets. It is associated with considerable morbidity and mortality. Incidence levels are rising worldwide.

Sources of data: Pubmed search (Nov 2010) using keywords: Type 1 diabetes, prevention, trials, immunotherapy.

Areas of agreement: The causes of disease are multifactorial with genetic and environmental factors playing a part. There is a long pre-clinical period before the onset of overt symptoms, which may be amenable to therapeutic intervention to prevent disease.

Areas of controversy: The exact nature of causative environmental factors is unknown and much debated. Immunotherapeutic intervention may therefore represent the best option for disease prevention.

Growing points: Enhancement of 'regulatory' immune mechanisms currently shows the most promise as an approach to disease prevention.

Areas timely for developing research: Clinical trials of early immunotherapeutic intervention may be the answer to disease prevention.