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Understanding Pre-Type 1 Diabetes: The Key to Prevention
Laura M Jacobsen1, Michael J Haller1, Desmond A Schatz1
1Division of Endocrinology, Department of Pediatrics, University of Florida, Gainesville, FL, United States.
Frontiers in Endocrinology
|March 22, 2018
Summary
Preventing type 1 diabetes remains a challenge despite rising incidence. Research into pre-type 1 diabetes and islet autoimmunity is crucial for developing effective prevention strategies and guiding future screening for children.
Area of Science:
- Immunology
- Endocrinology
- Diabetology
Background:
- Type 1 diabetes incidence is increasing annually, yet prevention remains elusive.
- Technological advancements like artificial pancreas systems aid management but do not offer a cure.
- Understanding the natural history of pre-type 1 diabetes is key to developing preventative measures.
Purpose of the Study:
- To review the current understanding of pre-type 1 diabetes natural history.
- To highlight the predictive value of islet autoimmunity and autoantibodies.
- To emphasize the need for prevention strategies and research.
Main Methods:
- Review of existing literature on type 1 diabetes natural history.
- Analysis of staging systems for pre-type 1 diabetes.
- Evaluation of the role of autoantibodies in disease prediction.
Main Results:
- Multiple autoantibodies are highly predictive of progression to type 1 diabetes.
- Staging systems aid in characterizing pre-type 1 diabetes and designing prevention studies.
- Close monitoring in natural history studies reduces diabetic ketoacidosis at diagnosis.
Conclusions:
- More research is essential to achieve the goal of preventing type 1 diabetes.
- Enrollment in research studies is currently the primary recommendation for autoantibody-positive individuals.
- An effective prevention strategy would support universal risk screening for all children.
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