Abstract
Insulin replacement therapy is considered the only effective and feasible treatment for type 1 diabetes mellitus (T1DM) as only insulin is capable
of reversing the metabolic disturbances and restoring a near - normal quality of life in patients with T1DM. Despite rigorous measures and major advances in health care provided for patients with T1DM, increased morbidity and mortality are still common from complications, which commonly develop within 10 – 12 years after clinical onset.
Advances in the understanding of the natural history of T1DM and increased abilities to predict the disease have made it possible to
design and implement prevention and intervention clinical trials. Clinical trials are aimed at: (a) preventing the initiation of islet
autoimmunity (primary prevention);(b)reducing autoimmune β-cell killing and progression to clinical diabetes (secondary prevention); or(c)suppressing or modulating the immune response in order to halt β-cell killing and enhance β-cell regeneration (tertiary prevention or intervention).
Several trials were implemented or are currently ongoing with dietary manipulation, parenteral or oral insulin or immune-suppressing or immune-modulating agents with the aim of preventing the disease or retarding its progression. The search for safe, effective and feasible drugs to prevent or cure T1DM is still ongoing. So far, immune modulation with alum - formulated GAD65 has been shown to be the most promising intervention to
reduce the loss of β-cells. Anti-CD3 monocloncal autoantibodies also showed some benefits in patients with newly diagnosed T1DM.
of reversing the metabolic disturbances and restoring a near - normal quality of life in patients with T1DM. Despite rigorous measures and major advances in health care provided for patients with T1DM, increased morbidity and mortality are still common from complications, which commonly develop within 10 – 12 years after clinical onset.
Advances in the understanding of the natural history of T1DM and increased abilities to predict the disease have made it possible to
design and implement prevention and intervention clinical trials. Clinical trials are aimed at: (a) preventing the initiation of islet
autoimmunity (primary prevention);(b)reducing autoimmune β-cell killing and progression to clinical diabetes (secondary prevention); or(c)suppressing or modulating the immune response in order to halt β-cell killing and enhance β-cell regeneration (tertiary prevention or intervention).
Several trials were implemented or are currently ongoing with dietary manipulation, parenteral or oral insulin or immune-suppressing or immune-modulating agents with the aim of preventing the disease or retarding its progression. The search for safe, effective and feasible drugs to prevent or cure T1DM is still ongoing. So far, immune modulation with alum - formulated GAD65 has been shown to be the most promising intervention to
reduce the loss of β-cells. Anti-CD3 monocloncal autoantibodies also showed some benefits in patients with newly diagnosed T1DM.
| Original language | English |
|---|---|
| Title of host publication | Textbook of Diabetes |
| Editors | Richard I. G. Holt, Clive S. Cockram, Allan Flyvbjerg, Barry J. Goldstein |
| Publisher | Wiley-Blackwell |
| Pages | 1001-1016 |
| ISBN (Print) | 9781405191814 |
| DOIs | |
| Publication status | Published - 2010 |
Subject classification (UKÄ)
- Clinical Medicine
