Materiały źródłowe

• #1 Preventing type 1 diabetes in childhood – PubMed

  https://pubmed.ncbi.nlm.nih.gov/34326231/

  Type 1 diabetes (T1D) is an autoimmune disease in which the insulin-producing cells of the pancreas are destroyed by T lymphocytes. Recent studies have demonstrated that monitoring for pancreatic islet autoantibodies, combined with genetic risk assessment, can identify most children who will develop T1D when they still have sufficient cell function to control glucose concentrations without the need for insulin. […] In addition, there has been recent success in secondary prevention using immunotherapy to delay the progression of preclinical disease, and primary prevention approaches to inhibiting the initiating autoimmune process have entered large-scale clinical trials. […] By changing the focus of T1D management from late diagnosis and insulin replacement to early diagnosis and cell preservation, we can anticipate a future without the need for daily insulin injections for children with T1D.

• #2 Type 1 diabetes in children – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/type-1-diabetes-in-children/symptoms-causes/syc-20355306

  There’s currently no sure way to prevent type 1 diabetes, but this is a very active area of research. […] The antibodies associated with type 1 diabetes in children who have a high risk of the disorder can be detected months or even years before the first symptoms of type 1 diabetes appear. Researchers are working on: […] Preventing or delaying the start of type 1 diabetes in people who have a high risk of the disease. […] Preventing further destruction of the islet cells in people who are newly diagnosed.

• #3 Prevention of Type 1 Diabetes in Children: A Worthy Challenge?

  https://pmc.ncbi.nlm.nih.gov/articles/PMC10252671/

  Nowadays, the development of new immuno-therapeutic drugs has made it possible to alter the course of many autoimmune diseases. […] The ability to intercept individuals at high risk of developing type 1 diabetes is the first step toward the development of therapies that can delay the process of -cell destruction, thus permitting a better glycemic control and reducing the incidence of ketoacidosis. […] In this review, we aim to give an overview of the most important clinical trials conducted during the primary, secondary and tertiary phases of prevention. […] The adoption of Eisenbarth and Insels pathogenetic staging of T1D has provided not only a standardized taxonomy, but also the possibility to identify subjects at risk of developing T1D, thus paving the way to its prevention. […] About 15,000 children and young adults who are first- or second-degree relatives of individuals with T1D are screened annually for islet autoantibodies through TrialNet.

• #4 Pathway to Prevention | Type 1 Diabetes TrialNet

  https://www.trialnet.org/our-research/risk-screening

  Pathway to Prevention screening is the first step for all TrialNet prevention studies. Screening is offered at no cost to eligible individuals to evaluate their personal risk of developing the disease. This unique screening can identify the early stages of type 1 diabetes (T1D) years before any symptoms appear. It also helps researchers learn more about how T1D develops and plan new studies exploring ways to prevent it. […] T1D risk screening will detect if you are in the early stages of T1D. Nearly all people that test positive for two or more diabetes-related autoantibodies will develop the disease. […] Individuals who have two or more autoantibodies are already in early stage T1D. The immune system has started attacking insulin-making beta cells. The lifetime risk of developing clinical diagnosis (stage 3) approaches 100%. […] Come in for a study visit that will include an Oral Glucose Tolerance Test (OGTT). It will show if you have abnormal blood sugar levels and help us determine if you are eligible for a prevention study or further close monitoring for development of T1D.

• #5 Prevention of Type 1 Diabetes in Children: A Worthy Challenge?

  https://pmc.ncbi.nlm.nih.gov/articles/PMC10252671/

  A formidable accomplishment of this approach comes from Bavaria, Germany in the so-called Fr1da study, where Ziegler et al. screened 90,632 pre-school children aged between 2 and 5 years during primary care visits. […] The long-term goal of the TEDDY study was the identification of infectious agents, dietary factors, or other environmental agents, including psychosocial factors, that could trigger or protect from T1D in genetically susceptible individuals. […] These studies not only demonstrate that screening programs for T1D are possible, but they also may reduce the clinical burden of ketoacidosis (DKA) thanks to an earlier diagnosis. […] As in many other chronic and non-communicable diseases, prevention consists of three levels of intervention: primary prevention, aimed at avoiding development of autoimmunity against islet autoantigens; secondary prevention, interfering instead with -cell destruction after the seroconversion; and finally, tertiary prevention, which is focused on preventing the clinical complications of T1D, with the main goal of delaying at least their onset, thus preserving residual cell-function.

• #6 Prevention of Type 1 Diabetes in Children: A Worthy Challenge?

  https://pmc.ncbi.nlm.nih.gov/articles/PMC10252671/

  Primary prevention should start from pregnancy, since the influence of several factors on the risk of developing T1D has been observed in this phase. […] The correlation between maternal weight and the risk of developing T1D has been analyzed in several studies. […] Thus, the prevention of excess weight and obesity in women of reproductive age may contribute to a decreased incidence of T1D. […] In addition, maternal infection during pregnancy is considered to be a risk factor for developing T1D. […] Prenatal protective factors for the development of autoimmunity include maternal vitamin D intake. […] All RCTs for the primary prevention of T1D have included early life dietary interventions and antigen-based therapy in newborns and toddlers, with the aim being to delay the loss of tolerance against pancreatic autoantigens.

• #7 Prevention opportunities of type 1 diabetes in children – MedCrave online

  https://medcraveonline.com/EMIJ/prevention-opportunities-of-type-1-diabetes-in-children.html

  Metabolic modifications, such as weight loss, increased physical activity, and -cell rest. […] The target population for primary prevention trials is young children who carry high-risk HLA-DR, DQ genotypes, especially in children of first-degree relatives. […] Ongoing primary prevention trials include largely low-risk dietary modifications: elimination of cow’s milk or gluten and supplementation of diet with n-3 fatty acids or vitamin D. […] The cow’s milk hypothesis is being tested by the Trial to Reduce type 1 diabetes in the Genetically at Risk (TRIGR). […] This randomized, double-masked trial is evaluating the effect of hydrolyzed infant formula, where protein fragments are too small to stimulate the immune system, compared with cow’s milk-based formula. […] The main end point of the trial is development of diabetes by the age of 10 years.

• #8 Prevention opportunities of type 1 diabetes in children – MedCrave online

  https://medcraveonline.com/EMIJ/prevention-opportunities-of-type-1-diabetes-in-children.html

  BABY DIET study is evaluating the effect of delaying exposure to gluten until the age of 1 year. […] Vitamin D supplementation in early childhood has attracted attention as a possible primary preventive measure. […] However, this interest has been mitigated by potential nephrotoxicity of vitamin D. […] In the past several years, trials in patients with newly diagnosed type 1 diabetes became the main focus of the research community, as it is easier to recruit participants after diagnosis of diabetes. […] The goal of tertiary prevention is preservation of remaining islet -cells to induce and prolong (partial) remission. […] A realistic outcome of tertiary prevention trials is prolongation of residual insulin secretion, rather than complete reversal of diabetes. […] Type 1 diabetes prevention research is expanding at an unprecedented rate, and prevention opportunities will have a bright future protecting our lovely children from this progressive epidemic.

• #9

  https://bjd-abcd.com/index.php/bjd/article/view/979

  This paper reviews data regarding the role of vitamin D in the genesis of type 1 diabetes (T1DM) and considers the hypothesis that vitamin D deficiency increases the incidence rate of T1DM. […] Vitamin D deficiency is common, particularly in the UK. […] Achieving this in Britain would require supplementing current intake with 1500-2000 IU vitamin D daily. Increased food fortification would be the most effective method. An estimate based on the limited data available suggests this might generate a 25-30% reduction in the incidence of T1DM.

• #10 Prevention of Type 1 Diabetes in Children: A Worthy Challenge?

  https://pmc.ncbi.nlm.nih.gov/articles/PMC10252671/

  Breast milk has been found to contain various anti-inflammatory bioactive molecules such as immunoglobulins, adipokines, oligosaccharides, insulin, lactoferrin, lysozyme, cytokines, beneficial bacteria and vitamins, which can give infants a lifelong immunity against many diseases, including T1D. […] Despite this, the association between breastfeeding and T1D remains controversial. […] Instead, based on the evidence in animal models that early exposure to cows milk proteins may increase the risk of -cell autoimmunity, the TRIGR (Trial to Reduce IDDM in Genetically at Risk) was the first to be proposed as a dietary RCT in 5156 infants at genetic risk for type 1 diabetes. […] Unfortunately, the use of a hydrolyzed formula compared with a conventional formula did not reduce the incidence of -cell autoimmunity after 7 years.

• #11 Prevention of Type 1 Diabetes: Past Experiences and Future Opportunities

  https://www.mdpi.com/2077-0383/9/9/2805

  The target population for primary prevention trials is individuals who carry high-risk genotypes before the first appearance of islet autoantibodies. […] The TRIGR study indicated that a hydrolyzed casein formula did not prevent from developing T1D in genetically at-risk children, and did not delay the onset of the disease. […] The Finnish Dietary Intervention Trial for the Prevention of T1D (FINDIA) showed that children receiving the bovine insulin-free had a reduced risk of developing one islet autoantibody compared to children on other formulas. […] This study concluded that late exposure to gluten did not decrease the risk of islet autoimmunity or the development of T1D in genetically at-risk children. […] Vitamin D supplementation in early life has attracted attention as playing a possible role in reducing the risk of T1D in later life.

• #12 Prevention of Type 1 Diabetes in Children: A Worthy Challenge?

  https://pmc.ncbi.nlm.nih.gov/articles/PMC10252671/

  Another dietary intervention trial is The Finnish Dietary Intervention Trial for the Prevention of Type 1 Diabetes (FINDIA), which assessed the impact of complete avoidance of bovine insulin in infants in Finland. […] Implementation in the diet of omega-3 fatty acids, whose anti-inflammatory properties are well known, has been associated with a lower risk of T1D. […] The Pilot Trial Nutritional Intervention to Prevent Type 1 Diabetes (NIP) was a double-blind placebo-controlled study of omega 3 fatty acid supplementation with docosahexaenoic acid (DHA). […] For all of these reasons, exploring the role of the microbiome may provide new highlights into developing safe strategies to modulate immune regulation in infants and children. […] The aim of prevention is to intervene during the early development of the disease by slowing or halting its progression. […] The first step in achieving valid results in prevention is to strengthen screening in the general population, and make them a part of the Standard of Care. […] Screening strategies could allow to identify individuals at risk for T1D in order to enroll them in clinical trials.

• #13 Prevention of Type 1 Diabetes: Past Experiences and Future Opportunities

  https://www.mdpi.com/2077-0383/9/9/2805

  Thus far, none of the specific dietary factors has been proved to be a definite risk factor halting or inducing beta-cell autoimmunity, and their effects have still been contradictory. […] More recently, primary intervention trials have started focusing on the modulation of the immune system by antigen-specific immunotherapy (ASI). […] The long-term observations have suggested that certain viral infections may promote the autoimmune attack directed to pancreatic beta-cell in genetically susceptible individuals. […] The link between T1D and CVB infection has prompted efforts to develop vaccines targeting CVBs. […] The CVB vaccine could be effective for the primary prevention of T1D by halting an induction of beta-cell autoimmunity. […] Secondary prevention is aimed to slow or halt the progressive beta-cell destruction in asymptomatic individuals with persistent islet autoantibodies (stage 1 and 2 of T1D).

• #14 Azthena logo with the word Azthena

  https://www.news-medical.net/health/Type-1-Diabetes-Prevention.aspx

  Some of the approaches to preventing type 1 diabetes include: […] Immunization – The basic premise of immunization is to alter the active state of the immune system from a Th1 state (the killer cell phase) to the Th2 state when new antibodies are developed. […] Use of DiaPep277 – This is a special protein or peptide fragment of a larger more common protein called the HSP60. This protein helps in bringing about the shift from Th1 to Th2 resulting in acquired immune tolerance. […] Insulin nasal spray – This approach also attempts to achieve a shift from the Th1 to the Th2 state by administering insulin to the immune cells within the nose. […] Use of BCG vaccine – The Bacillus Calmette-Gurin (BCG) vaccine is a vaccine used against tuberculosis. It helps produce tumor necrosis factor-alpha, or TNF-, which is deficient in people with type 1 diabetes. […] Use of the Diamyd vaccine – This involves injections of an autoantigen called GAD65. This delays the onset of disease in individuals who are susceptible to type 1 diabetes by producing the anti-inflammatory regulatory cytokines that protect the beta cells.

• #15 Type 1 diabetes mellitus: Prevention and disease-modifying therapy – UpToDate

  https://www.uptodate.com/contents/type-1-diabetes-mellitus-prevention-and-disease-modifying-therapy

  Type 1 diabetes mellitus: Prevention and disease-modifying therapy […] This topic will review strategies to prevent or delay clinical type 1 diabetes during preclinical stages of disease, as well as strategies to preserve insulin secretion after the onset of clinical disease. […] In individuals with preclinical (stage 1 or stage 2) type 1 diabetes, the goal of disease-modifying therapies is to prevent or delay the onset of clinical disease. […] Teplizumab, a humanized anti-CD3 monoclonal antibody, is the only therapy with regulatory approval in the United States for delaying the onset of clinical type 1 diabetes in individuals with preclinical disease. […] In the United States, teplizumab is approved for individuals aged 8 years and older who have stage 2 type 1 diabetes (≥2 diabetes-related autoantibodies and dysglycemia) and is administered as a single 14-day course of daily intravenous infusions. […] The availability of teplizumab represents a paradigm shift in the treatment of type 1 diabetes; with enhanced understanding of disease pathogenesis and progression, type 1 diabetes can be identified and treated in its preclinical stages before the development of symptomatic hyperglycemia.

• #16 Diabetes Mellitus in Children and Adolescents – Pediatrics – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/pediatrics/endocrine-disorders-in-children/diabetes-mellitus-in-children-and-adolescents

  Given the high rate of progression to symptomatic stages of type 1 diabetes and the prolonged preclinical period, disease-modifying therapies have been studied in an effort to prevent or delay the onset of clinical type 1 diabetes (stage 3). […] One such therapy is teplizumab. Teplizumab is an anti-CD3 monoclonal antibody. It can delay the onset of type 1 diabetes in people 8 years of age with preclinical (stage 2) diabetes. This medication is given as a single 14-day course of daily IV infusions. Adverse effects can include cytokine release syndrome (during the first 5 days), lymphopenia, rash, headache, fever, and nausea. […] In a randomized, controlled study, the median time to diagnosis of stage 3 type 1 diabetes was 48 months in the teplizumab group compared to 24 months in the placebo group. In an extended follow-up study (median 923 days) after teplizumab treatment, the median time to diagnosis was 59.6 months for people who received teplizumab compared to 27.1 months for people who received placebo. Additionally, 50% of the people who received teplizumab did not develop type 1 diabetes compared to 22% of the people who received placebo.

• #17 Breakthrough Drug Helps Children with New-Onset Type 1 Diabetes | UC San Francisco

  https://www.ucsf.edu/news/2023/10/426396/breakthrough-drug-helps-children-new-onset-type-1-diabetes

  Children who were recently diagnosed with type 1 diabetes need less supplemental insulin to keep their blood sugar in a healthy range if they use the immunotherapy drug teplizumab, a new study reports. […] Teplizumab, an immunotherapy drug, was approved by the FDA in 2022 thanks to a UCSF study showing that a 14-day dose of the drug delayed the onset of type 1 diabetes in at-risk children and adults by an average of three years. […] The findings, published October 18, 2023, in the New England Journal of Medicine, offer support for expanding treatment with teplizumab beyond its currently approved use for those who are at risk of developing type 1 diabetes but are not yet diagnosed. […] Many more of the teplizumab-treated patients experienced a clinical remission the ability to achieve tight blood sugar control using less supplemental insulin than those in the placebo group, Gitelman said.

• #18 Prevention of Type 1 Diabetes: Past Experiences and Future Opportunities

  https://www.mdpi.com/2077-0383/9/9/2805

  To date, screening studies have mainly included first-degree relatives of T1D patients. […] However, the actual mechanism of the effect of rituximab in T1D still is unclear and needs further investigations. […] Ultimately, primary prevention of islet autoimmunity will likely be the optimal approach to the prevention of T1D. […] If beta-cell autoimmunity is developed, there is still the potential therapeutic benefit of the intervention.

• #19 Clinical Research | Pediatric Diabetes | Wells Center for Pediatric Research | IU School of Medicine

  https://medicine.iu.edu/research-centers/pediatrics/research/diabetes/clinical

  The Type 1 diabetes clinical research team screens first and second degree relatives of people with Type 1 diabetes to assess risk for disease. The purpose of screening is to identify opportunities for earlier disease intervention and possible prevention. […] The purpose of this study is to determine if low-dose anti-thymocyte globulin (ATG) medicine can delay or prevent Type 1 diabetes in people who have more than a 50% risk of diagnosis within the next 2 years. […] The purpose of this observational study is to detect Type 1 diabetes at its earliest stages. Family members of people with Type 1 diabetes are screened for autoantibodies associated with Type 1 diabetes development. […] The purpose of this study is to investigate the potential of an oral medication difluoromethylornithine (DFMO) to alleviate stress on beta cells to preserve the body’s intrinsic capacity to produce insulin following diagnosis.

• #20 Type 1 diabetes mellitus: Prevention and disease-modifying therapy – UpToDate

  https://www.uptodate.com/contents/type-1-diabetes-mellitus-prevention-and-disease-modifying-therapy

  In individuals with clinical (stage 3) type 1 diabetes, the goal of disease-modifying therapy is to preserve beta cell function and insulin secretion. […] Preservation of endogenous insulin secretion after the clinical diagnosis of type 1 diabetes is associated with enduring benefits, including reduced risks of microvascular complications and severe hypoglycemia.

• #21 Recognising the Early Signs of Diabetes in Children is IMPORTANT as it may save your Child’s life! – Childhood Obesity Prevention

  https://childhoodobesityprevention.com.au/recognising-the-early-signs-of-diabetes-in-children/

  Type 1 diabetes (T1D) remains the most common form of diabetes in children and adolescents in Australia and world-wide, though more and more children are developing Type 2 diabetes (T2D) due to obesity and poor lifestyle. […] Early diagnosis and intervention are paramount, so read on to discover the warning signs and what to do. […] Early diagnosis and treatment are vital. Otherwise, if Type 1 diabetes goes untreated for too long, the life-threatening condition of diabetic ketoacidosis (DKA) develops and becomes a medical emergency. […] Here’s an educational video produced by Dr Gary Leong and his Children’s Diabetes team at Nepean Hospital for further information about the 4T symptoms of Diabetes and to prevent DKA. This might just save your child from becoming very sick with DKA and help them start their new life with diabetes in a positive and happier way.

• #22 T1D Screening and Prevention Program | Texas Children’s

  https://www.texaschildrens.org/departments/t1d-screening-and-prevention-program

  Screening and Intervention to Delay Type 1 Diabetes (T1D) is available via our telemedicine-based program called SIT Down T1D! The program is for children and adolescents under the age of 18 who are at risk for developing type 1 diabetes. […] Our goals are to delay type 1 diabetes, prevent diabetic ketoacidosis (DKA) and serve as a valuable resource to patients and families. […] By identifying T1D early, it may be possible to prevent the onset of diabetic ketoacidosis (DKA), one of the most serious outcomes of diabetes that includes high blood glucose and ketone levels. […] Tzield (teplizumab) is an FDA-approved medication now available for patients 8 years and older that has been shown to delay the onset of insulin-required T1D by approximately 2 years, on average.

• #23 Type 1 Diabetes | Diabetes | CDC

  https://www.cdc.gov/diabetes/about/about-type-1-diabetes.html

  Currently, type 1 diabetes can’t be prevented, but it can be treated effectively. […] Currently, no one knows how to prevent type 1 diabetes, but it can be managed successfully by: […] Healthy lifestyle habits are really important too: […] Regular appointments with your health care team can help you stay on track with your treatment plan and offer new ideas and strategies if needed.

• #24 Recognising the Early Signs of Diabetes in Children is IMPORTANT as it may save your Child’s life! – Childhood Obesity Prevention

  https://childhoodobesityprevention.com.au/recognising-the-early-signs-of-diabetes-in-children/

  The initial focus on starting insulin therapy ASAP, and if need be, on rehydrating the child and treating the high acid levels in the blood (acidosis) with insulin. […] It’s important to eat a healthy diet matched with insulin doses. Drinking plenty of water is also advisable. Children with T1D also need to remain physically active. This boosts the immune system, maintains an ideal body weight and lessens the symptoms associated with the condition.

• #25 Type 1 Diabetes: Causes, Symptoms, Complications & Treatment

  https://my.clevelandclinic.org/health/diseases/21500-type-1-diabetes

  Unfortunately, there’s nothing you can do to prevent developing Type 1 diabetes. […] Since Type 1 diabetes can run in families, your healthcare provider can test your family members for the autoantibodies that cause the disease. […] Type 1 Diabetes TrialNet, an international research network, also offers autoantibody testing to family members of people with Type 1 diabetes. […] The presence of autoantibodies, even without diabetes symptoms, means you’re more likely to develop Type 1 diabetes. […] If you have a sibling, child or parent with Type 1 diabetes, you may want to get an autoantibody test. […] These tests can help catch Type 1 diabetes in its earliest phases.

• #26 TrialNet: Imagining a Future without Type 1 Diabetes | Elizabeth Weiser Caswell Diabetes Institute

  https://diabetes.med.umich.edu/events-news/news/trialnet-imagining-future-without-type-1-diabetes

  According to Breakthrough T1D (previously known as JDRF), approximately 1.5 million children and adolescents under the age of 20 worldwide are living with type 1 diabetes. […] TrialNet, an international collaborative network, brings together physicians, scientists, and healthcare professionals dedicated to preventing type 1 diabetes and slowing its progression. […] Even though I do not like to have to tell someone that their child will develop type 1 diabetes, I know that families will use that information to keep their child healthier, either by continuing through our monitoring program which reduces the chance of a child presenting in diabetic ketoacidosis (DKA), enrolling their child in a prevention study or asking for a diabetes-delaying treatment such as Teplizumab. […] The Pathway to Prevention study is a global initiative aimed at identifying individuals at risk for Type 1 diabetes (T1D) and developing strategies to prevent or delay its onset.

• #27 TrialNet: Imagining a Future without Type 1 Diabetes | Elizabeth Weiser Caswell Diabetes Institute

  https://diabetes.med.umich.edu/events-news/news/trialnet-imagining-future-without-type-1-diabetes

  TrialNet is evaluating new interventions aimed at delaying the onset of T1D. […] New studies are currently open across the country. […] Through ongoing analysis, TrialNet is committed to making significant progress in the prevention of Type 1 diabetes. […] For those who have been diagnosed with stage 2 T1D, Michigan Medicine is offering TZIELD (teplizumab) infusions. This drug was studied through TrialNet and found to delay the onset of stage 3 T1D by a median of 2 years in children and adults at high risk. […] TrialNet is focused on early diagnosis which is meant to reduce the risk of the life-threatening presenting symptoms.

• #28 Type 1 Diabetes Prevention Program at CHOP | Children’s Hospital of Philadelphia

  https://www.chop.edu/news/type-1-diabetes-prevention-program-chop

  Tzield, the first FDA-approved treatment to delay the onset of clinical diabetes, is now available for children who need it. […] This treatment, also called teplizumab, addresses the underlying autoimmune process of type 1 diabetes (T1D) and can delay the onset of clinical diabetes by up to two years. […] Since early identification is crucial to ensure timely initiation of treatment, Childrens Hospital of Philadelphia (CHOP) has developed a specialized clinic designed for at-risk children. Our mission is to provide monitoring and treatment options for those who are eligible. The program also tracks those who may be at risk but do not yet qualify for treatment and closely monitors individuals receiving treatment. […] We offer screening services and provide access to clinical research trials aimed at preventing T1D for individuals diagnosed in the early stages. Screening for T1D allows for early detection and can help prevent diabetic ketoacidosis, potentially reducing prolonged hospitalizations and the emotional strain of caring for a sick child.

• #29 Symptoms, Treatment and Prevention of Type 1 Diabetes | Children’s Hospital Los Angeles

  https://www.chla.org/blog/advice-experts/symptoms-treatment-and-prevention-type-1-diabetes

  Currently there are no known therapies that can alter the immune system, prevent it from destroying beta cells, and hence prevent T1D. […] However, there are many researchers nationally and internationally who are looking at immunomodulators, which are medications that can alter the immune system, to try to prevent T1D. […] TrialNet is an international network of researchers who are exploring ways to prevent, delay and reverse the progression of type 1 diabetes. […] TrialNets main areas of research are screening family members of people with T1D to assess their risk for developing T1D, and evaluating the efficacy of immunomodulators in preventing T1D in at risk individuals and slowing the progression of T1D in recently diagnosed people.

• #30

  https://journals.lww.com/indjem/fulltext/2023/07000/prevention_of_type_1_diabetes__current_perspective.2.aspx

  These strategies essentially include avoidance of exposure to suspected environmental factors in genetically predisposed populations. […] Environmental factors worth mentioning include exposure to cows milk and gluten. […] Therapies involving anti-inflammatory action or immunity-modulating action in general, like the use of docosahexaenoic acid, vitamin D, and high-dose nicotinamide, have been tried with unsuccessful results. […] However, antigenic-specific therapies to induce immune desensitization using the principle of bystander suppression continue to pique the interest of scientists. […] Teplizumab has provided the right kind of morale booster to the field of T1D prevention which had seen dismal results so far. […] Teplizumab delays the onset of T1DM by months-years and does not fully prevent it. […] Although this by itself is a significant milestone with the potential to reduce the burden of patients and caregivers, the future, we hope, should hold a promise for the total prevention of T1DM.

• #31 Disease-modifying therapies and features linked to treatment response in type 1 diabetes prevention: a systematic review | Communications Medicine

  https://www.nature.com/articles/s43856-023-00357-y

  Type 1 diabetes (T1D) results from immune-mediated destruction of insulin-producing beta cells. Prevention efforts have focused on immune modulation and supporting beta cell health before or around diagnosis; however, heterogeneity in disease progression and therapy response has limited translation to clinical practice, highlighting the need for precision medicine approaches to T1D disease modification. […] To facilitate precision medicine approaches to T1D prevention, considerations for future precision studies include the incorporation of uniform outcome measures, reproducible biomarkers, and prespecified, fully powered precision analyses into future trial design. […] T1D development occurs along a spectrum of progressive beta cell destruction, beginning with loss of tolerance, reflected by the appearance of islet autoantibodies, and continuing with progressive hyperglycemia, abnormal glucose tolerance, and decline in endogenous insulin production, reflected by a decline in C-peptide.

• #32 Disease-modifying therapies and features linked to treatment response in type 1 diabetes prevention: a systematic review | Communications Medicine

  https://www.nature.com/articles/s43856-023-00357-y

  While an ideal goal is clinical T1D prevention, disease-modifying agents aimed throughout the spectrum of T1D progression have the potential to improve long-term outcomes. […] Given widely available participants and shorter total trial durations, agents planning to target earlier stages of the disease are often initially trialed in the new-onset period. […] We sought to understand the current state of knowledge regarding precision approaches to T1D disease modification, either to prevent the development of early-stage or clinical T1D (referred to as prevention studies) or to preserve endogenous insulin function around the time of clinical T1D diagnosis (referred to as new-onset studies). […] We reviewed and summarized existing trials in this area and identified individual characteristics associated with treatment effects. […] Time to T1D was the most consistent primary outcome of T1D prevention studies, but inclusion criteria for these studies varied widely across trials, including combinations of genetic risk, presence of islet autoantibodies, and changes in glycemia and/or beta cell function.

• #33 Prevention of Type 1 Diabetes in Children: A Worthy Challenge?

  https://ouci.dntb.gov.ua/en/works/9jA1zeql/

  Prevention of Type 1 Diabetes in Children: A Worthy Challenge? […] The ability to intercept individuals at high risk of developing type 1 diabetes is the first step toward the development of therapies that can delay the process of β-cell destruction, thus permitting a better glycemic control and reducing the incidence of ketoacidosis. […] In this review, we aim to give an overview of the most important clinical trials conducted during the primary, secondary and tertiary phases of prevention. […] Screening of Islet Autoantibodies for Children in the General Population: A Position Statement Endorsed by the European Society for Paediatric Endocrinology. […] Early clinical diagnosis of type 1 diabetes may be beneficial for metabolic control and remission after 3 years of follow-up. […] Strategies for reversing T1D involve combination immunotherapies to block autoimmunity and regenerate beta cells via stem cells or xenotransplantation. […] Innovative and multi-targeted therapies may fundamentally change the trajectory of T1D.

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