[Immunoprevention of Type I diabetes mellitus]

The ability to diagnose type I diabetes at an early stage and to identify individuals at high risk by immunologic and immunogenetic testing raises the possibility of intervention to prevent the disease. At present, three possible intervention strategies are being studied: first preservation of residual-beta-cell mass by nicotinamide, second prophylactic periodic insulin treatment and third tolerance induction by oral antigen (insulin) therapy. The rationale behind these immune intervention strategies is reviewed and the presently ongoing trials are outlined.