Article

Prevention of type 1 diabetes: today and tomorrow.

Diabetes, Nutrition and Metabolic Diseases Outpatient Unit, Târgu Mureş Emergency County Clinical Hospital, 50Gheorghe Marinescu Str., Târgu Mureş, Romania.
Diabetes/Metabolism Research and Reviews (impact factor: 3.37). 10/2010; 26(8):602-5. DOI:10.1002/dmrr.1138
Source: PubMed

ABSTRACT The aim of therapeutic interventions for type 1 diabetes is to suppress pathogenic autoreactivity and to preserve/restore beta-cell mass and function to physiologically sufficient levels to maintain good metabolic control. During the natural history of type 1 diabetes, several strategies have been applied at various stages in the form of primary, secondary or tertiary prevention approaches. Clinical trials using antigen-specific (e.g. DiaPep277, human glutamic acid decarboxylase 65 (GAD65)) or non-specific immune therapies (e.g. anti-CD3 monoclonal antibodies) have shown some benefit in the modulation of the autoimmune process and prevention of the insulin secretion loss in the short term after diagnosis of diabetes. A single long-term effective therapy has not been identified yet, and it is likely that in most cases a rationally designed combinatorial approach using immunotherapeutic methods coupled with islet regeneration or replacement will prove to be most effective.

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Keywords

anti-CD3 monoclonal antibodies
 
autoimmune process
 
cases
 
Clinical trials
 
combinatorial approach
 
human glutamic acid decarboxylase 65
 
insulin secretion loss
 
natural history
 
non-specific immune therapies
 
physiologically sufficient levels
 
preserve/restore beta-cell mass
 
short term
 
single long-term effective therapy
 
tertiary prevention approaches
 
type 1 diabetes