When and how will we be able to prevent type 1 diabetes?

When and how will we be able to prevent type 1 diabetes?

There are a number of approaches that might reasonably lead to the prevention of type 1 diabetes in the foreseeable future. Although hereditary factors are involved in a person’s risk of getting type 1 diabetes, it is clear that there is an important trigger in the environment.

For example, if one of a pair of identical twins has type 1 diabetes, the chance of the other twin getting the disease is smaller than 50%. Definite identification of a major risk factor (such as an infectious agent, nutrient, or other chemical) could lead to effective protection against exposure or immunization against it. Whatever the trigger may be, the process that ultimately leads to type 1 diabetes is caused by the body’s immune system, which activates a destructive attack on the insulinproducing cells of the pancreas.

There are a number of ways in which this destructive process can be slowed or suppressed. Earlier efforts were either ineffective or led to a general suppression of the body’s immune system, increasing the risk of infections. However, clinical trials of drugs that specifically target the self-destructive process in the
pancreas are presently underway.

These treatments require prolonged administration into the blood vessels over several days and often have unpleasant side effects. Also, to be truly preventive, they must be given when early evidence of future diabetes is discovered, but before the actual onset of diabetes, by which time intense and often irreversible destruction of the insulin-producing cells has already occurred. It is probable that it will be several years before any of these drugs is readily available.

There is a great deal of investigation currently ongoing into the development of stem cells for use as replacements for lost insulin-producing cells. Stem cells are a small proportion of cells in tissues and organs that have not yet developed into final form. As such, when treated in a certain way, they can be persuaded to
commit themselves to developing into one specific desired type of cell. There are a lot of questions remaining to be answered regarding the safety, effectiveness, and durability of stem cell treatments and there remains the issue that the immune system problem that destroyed the original insulin-producing cells might also destroy their replacements. However, clinical trials are underway in other diseases which, if successful, could accelerate interest in the use of stem cells for type 1 diabetes.