Prevention of IDDM: a public health perspective

Insulin dependent diabetes mellitus (IDDM) poses a large social and economic burden on society. There are now methods for identifying persons at risk for IDDM and increasing evidence suggest that it may be possible to delay or even prevent the clinical presentation of the disease. This raises the question of whether a prevention program for IDDM should be initiated through public health channels. Review of the literature suggests that in spite of the considerable societal burden associated with diabetes, there are currently no broadly applicable, effective methods for identifying persons at increased risk of developing IDDM nor are there proven strategies for its prevention when risk is established. Until strategies to identify persons at risk of IDDM and methods to prevent the onset of disease are established, a better use of limited resources may be the secondary and tertiary prevention of complications of the disease.