Skip to main content

Advertisement

Log in

Can We Prevent Type 1 Diabetes?

  • Treatment of Type 1 Diabetes (M Pietropaolo, Section Editor)
  • Published:
Current Diabetes Reports Aims and scope Submit manuscript

Abstract

Type 1 diabetes (T1D) affects 1.93 in 1000 youth in the USA. Over the last 40 years, a combination of genetic and immunological markers has been developed allowing for the accurate prediction of progression to T1D. Despite our abilities to predict disease and the marked improvement in our understanding of the natural history of T1D, therapies capable of preventing or reversing T1D remain elusive. This article will review recent and ongoing efforts to understand the causes of T1D and related efforts to study potential therapies aimed at preventing T1D.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1

Similar content being viewed by others

References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. Atkinson MA, Eisenbarth GS, Michels AW. Type 1 diabetes. Lancet. 2014;383:69–82. In-depth review of the natural history of type 1 diabetes.

    Article  PubMed Central  PubMed  Google Scholar 

  2. Winter W. Diabetes autoimmunity. In: Lifshitz F, ed. Pediatric endocrinology: Informa Healthcare.2007;83-99.

  3. Winter W. Autoimmune disorders that influence carbohydrate metabolism. Clinical and laboratory evaluation of human autoimmune diseases. Chicago, IL: ASCP Press.2002;345-72.

  4. Akerblom HK, Knip M. Putative environmental factors in type 1 diabetes. Diabetes Metab Rev. 1998;14:31–67.

    Article  CAS  PubMed  Google Scholar 

  5. Hummel M, Bonifacio E, Schmid S, Walter M, Knopff A, Ziegler AG. Brief communication: early appearance of islet autoantibodies predicts childhood type 1 diabetes in offspring of diabetic parents. Ann Intern Med. 2004;140:882–6.

    Article  PubMed  Google Scholar 

  6. Jahromi MM, Eisenbarth GS. Cellular and molecular pathogenesis of type 1A diabetes. Cell Mol Life Sci. 2007;64:865–72.

    Article  CAS  PubMed  Google Scholar 

  7. American Diabetes A. Economic costs of diabetes in the U.S. in 2012. Diabetes Care. 2013;36:1033–46. Economists review of the cost associated with diabetes in the US.

    Article  Google Scholar 

  8. Group TS. The Environmental Determinants of Diabetes in the Young (TEDDY) study: study design. Pediatr Diabetes. 2007;8:286–98.

    Article  Google Scholar 

  9. Ziegler AG, Rewers M, Simell O, et al. Seroconversion to multiple islet autoantibodies and risk of progression to diabetes in children. JAMA. 2013;309:2473–9. Autoantibody prediction of progression to T1D.

    Article  CAS  PubMed  Google Scholar 

  10. Vehik K, Hamman RF, Lezotte D, et al. Trends in high-risk HLA susceptibility genes among Colorado youth with type 1 diabetes. Diabetes Care. 2008;31:1392–6.

    Article  PubMed Central  PubMed  Google Scholar 

  11. Ziegler AG, Hummel M, Schenker M, Bonifacio E. Autoantibody appearance and risk for development of childhood diabetes in offspring of parents with type 1 diabetes: the 2-year analysis of the German BABYDIAB Study. Diabetes. 1999;48:460–8.

    Article  CAS  PubMed  Google Scholar 

  12. Haller MJ, Atkinson MA, Schatz D. Type 1 diabetes mellitus: etiology, presentation, and management. Pediatr Clin N Am. 2005;52:1553–78.

    Article  Google Scholar 

  13. Knip M, Akerblom HK, Becker D, et al. Hydrolyzed infant formula and early beta-cell autoimmunity: a randomized clinical trial. JAMA. 2014;311:2279–87. TRIGR study results.

    Article  PubMed Central  PubMed  Google Scholar 

  14. Vaarala O, Ilonen J, Ruohtula T, et al. Removal of bovine insulin from cow’s milk formula and early initiation of beta-cell autoimmunity in the FINDIA pilot study. Arch Pediatr Adolesc Med. 2012;166:608–14.

    Article  PubMed  Google Scholar 

  15. Schmid S, Buuck D, Knopff A, Bonifacio E, Ziegler AG. BABYDIET, a feasibility study to prevent the appearance of islet autoantibodies in relatives of patients with type 1 diabetes by delaying exposure to gluten. Diabetologia. 2004;47:1130–1.

    Article  CAS  PubMed  Google Scholar 

  16. Hummel S, Pfluger M, Hummel M, Bonifacio E, Ziegler AG. Primary dietary intervention study to reduce the risk of islet autoimmunity in children at increased risk for type 1 diabetes: the BABYDIET study. Diabetes Care. 2011;34:1301–5.

    Article  PubMed Central  PubMed  Google Scholar 

  17. Chase HP, Boulware D, Rodriguez H, et al. Effect of docosahexaenoic acid supplementation on inflammatory cytokine levels in infants at high genetic risk for type 1 diabetes. Pediatr Diabetes. 2015;16:271. NIP Study results.

    Article  CAS  PubMed  Google Scholar 

  18. Frederiksen B, Kroehl M, Lamb MM, et al. Infant exposures and development of type 1 diabetes mellitus: the Diabetes Autoimmunity Study in the Young (DAISY. JAMA Pediatr. 2013;167:808–15. Daisy Study Results.

    Article  PubMed Central  PubMed  Google Scholar 

  19. Norris JM, Yin X, Lamb MM, et al. Omega-3 polyunsaturated fatty acid intake and islet autoimmunity in children at increased risk for type 1 diabetes. JAMA. 2007;298:1420–8.

    Article  CAS  PubMed  Google Scholar 

  20. Atkinson MA, Maclaren NK, Luchetta R. Insulitis and diabetes in NOD mice reduced by prophylactic insulin therapy. Diabetes. 1990;39:933–7.

    Article  CAS  PubMed  Google Scholar 

  21. Skyler JS, Krischer JP, Wolfsdorf J, et al. Effects of oral insulin in relatives of patients with type 1 diabetes: the Diabetes Prevention Trial—Type 1. Diabetes Care. 2005;28:1068–76.

    Article  CAS  PubMed  Google Scholar 

  22. Vehik K, Cuthbertson D, Ruhlig H, et al. Long-term outcome of individuals treated with oral insulin: diabetes prevention trial-type 1 (DPT-1) oral insulin trial. Diabetes Care. 2011;34:1585–90.

    Article  PubMed Central  PubMed  Google Scholar 

  23. Vehik K, Beam CA, Mahon JL, et al. Development of autoantibodies in the TrialNet Natural History Study. Diabetes Care. 2011;34:1897–901.

    Article  PubMed Central  PubMed  Google Scholar 

  24. Mahon JL, Sosenko JM, Rafkin-Mervis L, et al. The TrialNet Natural History Study of the Development of Type 1 Diabetes: objectives, design, and initial results. Pediatr Diabetes. 2009;10:97–104.

    Article  PubMed  Google Scholar 

  25. Bonifacio E, Ziegler AG, Klingensmith G, et al. Effects of high-dose oral insulin on immune responses in children at high risk for type 1 diabetes: the Pre-POINT randomized clinical trial. JAMA. 2015;313:1541–9. Pre-Point Results.

    Article  CAS  PubMed  Google Scholar 

  26. Ziegler AG, Bonifacio E, Group B-BS. Age-related islet autoantibody incidence in offspring of patients with type 1 diabetes. Diabetologia. 2012;55:1937–43.

    Article  CAS  PubMed  Google Scholar 

  27. Skyler JS. Primary and secondary prevention of Type 1 diabetes. Diabet Med. 2013;30:161–9. Review of current primary and secondary prevention efforts.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  28. Wherrett DK, Bundy B, Becker DJ, et al. Antigen-based therapy with glutamic acid decarboxylase (GAD) vaccine in patients with recent-onset type 1 diabetes: a randomised double-blind trial. Lancet. 2011;378:319–27.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  29. Andersson C, Carlsson A, Cilio C, et al. Glucose tolerance and beta-cell function in islet autoantibody-positive children recruited to a secondary prevention study. Pediatr Diabetes. 2013;14:341–9.

    Article  CAS  PubMed  Google Scholar 

  30. Curtsinger JM, Mescher MF. Inflammatory cytokines as a third signal for T cell activation. Curr Opin Immunol. 2010;22:333–40.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  31. Abrams JR, Lebwohl MG, Guzzo CA, et al. CTLA4Ig-mediated blockade of T-cell costimulation in patients with psoriasis vulgaris. J Clin Invest. 1999;103:1243–52.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  32. Genant HK, Peterfy CG, Westhovens R, et al. Abatacept inhibits progression of structural damage in rheumatoid arthritis: results from the long-term extension of the AIM trial. Ann Rheum Dis. 2008;67:1084–9.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  33. Lenschow DJ, Ho SC, Sattar H, et al. Differential effects of anti-B7-1 and anti-B7-2 monoclonal antibody treatment on the development of diabetes in the nonobese diabetic mouse. J Exp Med. 1995;181:1145–55.

    Article  CAS  PubMed  Google Scholar 

  34. Orban T, Bundy B, Becker DJ, et al. Co-stimulation modulation with abatacept in patients with recent-onset type 1 diabetes: a randomised, double-blind, placebo-controlled trial. Lancet. 2011;378:412–9.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  35. Atkinson MA, von Herrath M, Powers AC, Clare-Salzler M. Current concepts on the pathogenesis of type 1 diabetes-considerations for attempts to prevent and reverse the disease. Diabetes Care. 2015;38:979–88. Recent review of prevention and reversal efforts.

    Article  CAS  PubMed  Google Scholar 

  36. Herold KC, Hagopian W, Auger JA, et al. Anti-CD3 monoclonal antibody in new-onset type 1 diabetes mellitus. N Engl J Med. 2002;346:1692–8.

    Article  CAS  PubMed  Google Scholar 

  37. Herold KC, Gitelman SE, Willi SM, et al. Teplizumab treatment may improve C-peptide responses in participants with type 1 diabetes after the new-onset period: a randomised controlled trial. Diabetologia. 2013;56:391–400. Anti-CD3 results in new onsets.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

Download references

Compliance with Ethics Guidelines

Conflict of Interest

Giovanna Beauchamp and Michael J. Haller declare they have no conflicts of interest.

Human and Animal Rights and Informed Consent

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. All applicable international, national, and/or institutional guidelines for the care and use of animals were followed.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Michael J. Haller.

Additional information

This article is part of the Topical Collection on Treatment of Type 1 Diabetes

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Beauchamp, G., Haller, M.J. Can We Prevent Type 1 Diabetes?. Curr Diab Rep 15, 86 (2015). https://doi.org/10.1007/s11892-015-0658-6

Download citation

  • Published:

  • DOI: https://doi.org/10.1007/s11892-015-0658-6

Keywords

Navigation