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Preventing type 1 diabetes in childhood

2021; American Association for the Advancement of Science; Volume: 373; Issue: 6554 Linguagem: Inglês

10.1126/science.abi4742

1095-9203

Colin Dayan, Rachel Besser, Richard A. Oram, William Hagopian, Manu Vatish, Owen Bendor-Samuel, Matthew D. Snape, John A. Todd,

Pancreatic function and diabetes

Type 1 diabetes (T1D) is an autoimmune disease in which the insulin-producing β 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 β 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 β cell preservation, we can anticipate a future without the need for daily insulin injections for children with T1D.