Prevention of Type 1 Diabetes Mellitus

At present type-1 diabetes is not a preventable disease. But there are several preventive therapies currently under study and emerging and many of the preventive therapies are showing promising results. Due to promising potentials of preventive therapies we can hope to be able to prevent type-1 diabetes before it manifests, at the latent autoimmune stage, by use of different preventive therapies, if required.

There are several different approaches currently under evaluation for prevention of type-1 diabetes, such as diet, immunosuppressant drugs, T-helper cell shift, vaccine (GAD65 vaccine is under study) etc.

Diet in prevention of type 1 diabetes:

Several researches have shown that breastfeeding for adequate duration can reduce risk of developing diabetes in later life. There are also various other nutritional factors (some are protective and some are with potential risk for diabetes type-1) important in diabetes, but no conclusive evidence is yet available. For example, administration of 2,000 IU (international unit) of vitamin-D is found to be protective, but sufficient evidence is lacking.

Immunosuppressant drugs in prevention of type 1 diabetes:

Cyclosporine A (an immunosuppressant drug) can prevent and halt destruction of beta cells of pancreas, which produce insulin, but high side effect profile of Cyclosporine A makes it unsuitable for long term use.

Anti CD3 antibodies (such as teplizumab, otelixizumab etc.) and anti CD20 antibodies (rituximab), has been shown to preserve insulin production is type-1 diabetes patients, bt their long term effects are not satisfactory.

T-helper cell shift in prevention of type 1 diabetes:

Research is going on to find out ways to prevent immune system from attacking beta cells of pancreas and prevent development of type-1 diabetes. Researchers are trying to do it by making the activation state of the immune system to change from type 1 Helper T cells or Th1 type to Th2 type.

GAD65 vaccine in prevention of type 1 diabetes:

Vaccines are under trial for type-1 diabetes using GAD65, which is an auto-antigen responsible for development of type-1 diabetes. In clinical trials, administration of GAD65 vaccine within 6 months of diagnosis has shown to delay destruction of beta cells.

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