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Diabetes - type 1

Description

An in-depth report on the causes, diagnosis, and treatment of type 1 diabetes.

Alternative Names

Type 1 diabetes; Insulin-dependent diabetes; Juvenile diabetes

Prevention

Fingerstick blood tests are now available that can test for autoantibodies that identify children who are at high risk for developing type 1 diabetes. At this time, however, there is no way to prevent type 1 diabetes and all preventive therapies are investigative. Until there are ways to prevent the condition, such screening tests are expensive and provide little value.

Although insulin is the mainstay of type 1 diabetes treatment, research is ongoing to develop other approaches that might, in time, even be curative. The basis for nearly all experimental measures for prevention and treatment of type 1 diabetes is stabilization of beta cells. Preventive measures are sometimes defined as primary and secondary:

• Primary prevention attempts to preserve all beta cells before the disease process starts.
• Secondary prevention hopes to deter further beta cell destruction once it has started and before symptoms arise.

The following are some investigative approaches.

• One approach uses the body's own immune system to impede or prevent beta-cell destruction. Genetically designed antibodies called monoclonal antibodies (MAbs) are being developed that target factors believed to trigger the disease process. In a small 2002 study, for example, the use of an anti-CD3 MAb helped maintain residual insulin or even improve insulin production in 9 out of 12 patients over the course of a year. More studies are underway.
• Another target is insulin-like growth factor-I (IFG-I), which regulates islet beta cell and protects against type 1 diabetes. The substance itself is unstable, however. Researchers are looking for similar compounds that may be a more reliable source for drug development. One such drug, IGF-I/IGFBP-3 complex, is showing promise.

A unique anti-inflammatory compound, lisofylline, inhibited immune factors that attacked beta cells in mouse studies. Human trials are probably years away.

• Review Date: 7/18/2006
• Reviewed By: Harvey Simon, M.D., Editor-in-Chief, Associate Professor of Medicine, Harvard Medical School; Physician, Massachusetts General Hospital

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