Primary and secondary prevention of Type 1 diabetes

Research output: Contribution to journalArticle

51 Citations (Scopus)

Abstract

Since type 1 diabetes is an immunologically mediated disease, immune intervention should alter the natural history of the disease. This article reviews prevention studies undertaken either prior to any evidence of autoimmunity (primary prevention) or after the development of islet autoantibodies (secondary prevention). Most immune intervention studies have been conducted in recent-onset type 1 diabetes (tertiary prevention), and these are not reviewed herein. The goal of primary and secondary intervention is to arrest the immune process and thus prevent or delay clinical disease. Primary prevention studies have been conducted in infants with high genetic risk. Interventions tested include several dietary manipulations, including infant formulas free of either cow's milk or of bovine insulin, infant formula supplemented with the omega-3-fatty acid docosahexaenoic acid, delayed introduction of gluten-containing foods, and vitamin D supplementation. Secondary prevention studies have been conducted in both children and adults with diabetes autoantibodies. Interventions tested include nicotinamide, insulin injections, oral insulin, nasal insulin, glutamic acid decarboxylase, and cyclosporine. Underway are secondary prevention studies with teplizumab and with abatacept.

Original languageEnglish
Pages (from-to)161-169
Number of pages9
JournalDiabetic Medicine
Volume30
Issue number2
DOIs
StatePublished - Feb 1 2013

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Primary Prevention
Secondary Prevention
Type 1 Diabetes Mellitus
Insulin
Infant Formula
Autoantibodies
Tertiary Prevention
Glutamate Decarboxylase
Niacinamide
Docosahexaenoic Acids
Glutens
Immune System Diseases
Omega-3 Fatty Acids
Autoimmunity
Nose
Vitamin D
Cyclosporine
Milk
Food
Injections

ASJC Scopus subject areas

  • Endocrinology
  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism

Cite this

Primary and secondary prevention of Type 1 diabetes. / Skyler, Jay S.

In: Diabetic Medicine, Vol. 30, No. 2, 01.02.2013, p. 161-169.

Research output: Contribution to journalArticle

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