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Preventing type 1 diabetes in childhood
Colin M Dayan1,2, Rachel E J Besser3, Richard A Oram4
1Wellcome Centre for Human Genetics, Nuffield Department of Medicine, National Institute for Health Research (NIHR) Biomedical Research Centre, University of Oxford, Oxford, UK. dayancm@cardiff.ac.uk.
Science (New York, N.Y.)
|July 30, 2021
Summary
Early detection of type 1 diabetes (T1D) through autoantibody and genetic screening can identify at-risk children. This allows for interventions to preserve insulin-producing cells, potentially eliminating the need for daily insulin injections.
Area of Science:
- Immunology
- Endocrinology
- Pediatrics
Background:
- Type 1 diabetes (T1D) is an autoimmune condition where pancreatic beta cells are destroyed by T lymphocytes.
- Current management focuses on insulin replacement after diagnosis.
Purpose of the Study:
- To shift T1D management towards early diagnosis and beta cell preservation.
- To explore the potential for preventing or delaying the need for insulin therapy in children.
Main Methods:
- Monitoring of pancreatic islet autoantibodies.
- Genetic risk assessment in children.
- Evaluating immunotherapy for secondary prevention of T1D progression.
- Assessing primary prevention strategies targeting the autoimmune process.
Main Results:
- Identification of most children at risk for T1D before significant beta cell loss.
- Successful secondary prevention trials delaying disease progression.
- Primary prevention trials have entered large-scale clinical studies.
Conclusions:
- Early diagnosis and beta cell preservation are key to altering T1D management.
- A future free from daily insulin injections for children with T1D is anticipated.
- Proactive strategies can prevent autoimmune destruction of pancreatic beta cells.
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