Preventing type 1 diabetes mellitus: hype and hope

Autoimmune diseases affect 10% or more of the UK population. In organ-specific autoimmune diseases a particular tissue is targeted by the aggressive immune response. Type 1 diabetes is due to destruction of insulin-secreting islet cells. Both genetic and environmental factors cause type 1 diabetes and environmental events can operate very early, even in utero. The early induction of diabetes-associated autoantibodies and the long prediabetic period means that autoimmune diabetes in children can be predicted by detecting these autoantibodies. The purpose of prediction is prevention and initial studies suggest that it is possible to modify the disease process. However, the impact of such therapy on the disease is as yet extremely modest.