A Swedish approach to the prevention of type 1 diabetes

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A Swedish approach to the prevention of type 1 diabetes. / Elding Larsson, Helena.

I: Pediatric Diabetes, Vol. 17, Nr. S22, 01.07.2016, s. 73-77.

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TY - JOUR

T1 - A Swedish approach to the prevention of type 1 diabetes

AU - Elding Larsson, Helena

PY - 2016/7/1

Y1 - 2016/7/1

N2 - Background: The autoimmune destruction of beta cells, resulting in clinical type 1 diabetes, may start early in life and last for several months or years. During this period of time, we have an opportunity to try to prevent or delay further beta-cell destruction and clinical onset of type 1 diabetes. Objectives: Ongoing prediction and prevention studies in Skåne, Sweden are described. Methods: During September 2000 to August 2004, 35 000 children were screened at birth for genetic type 1 diabetes risk in the Diabetes Prediction in Skåne Study (DiPiS). In August 2004, the screening continued within the Enviromnental Determinants of Diabetes in the Young study (TEDDY). In the clinical trial Diabetes Prevention – Immune Tolerance (DiAPREV-IT), children with multiple islet autoimmunity have been included to investigate if immune tolerance with Alum-formulated GAD65 may prevent further beta-cell loss. Results: In DiPiS and TEDDY, a large number of children are followed in order to find the factors that trigger the autoimmune process leading to type 1 diabetes. Children followed in the studies develop diabetes at an early stage of disease, with few symptoms and a low frequency of diabetes ketoacidosis. DiAPREV-IT is still blinded and results will be available in December 2016. Conclusion: Large prospective studies will be needed to understand the complex process leading to type 1 diabetes. Secondary prevention may be possible in children with islet autoimmunity, but the studies are complicated by the variability of glucose metabolism and beta-cell loss.

AB - Background: The autoimmune destruction of beta cells, resulting in clinical type 1 diabetes, may start early in life and last for several months or years. During this period of time, we have an opportunity to try to prevent or delay further beta-cell destruction and clinical onset of type 1 diabetes. Objectives: Ongoing prediction and prevention studies in Skåne, Sweden are described. Methods: During September 2000 to August 2004, 35 000 children were screened at birth for genetic type 1 diabetes risk in the Diabetes Prediction in Skåne Study (DiPiS). In August 2004, the screening continued within the Enviromnental Determinants of Diabetes in the Young study (TEDDY). In the clinical trial Diabetes Prevention – Immune Tolerance (DiAPREV-IT), children with multiple islet autoimmunity have been included to investigate if immune tolerance with Alum-formulated GAD65 may prevent further beta-cell loss. Results: In DiPiS and TEDDY, a large number of children are followed in order to find the factors that trigger the autoimmune process leading to type 1 diabetes. Children followed in the studies develop diabetes at an early stage of disease, with few symptoms and a low frequency of diabetes ketoacidosis. DiAPREV-IT is still blinded and results will be available in December 2016. Conclusion: Large prospective studies will be needed to understand the complex process leading to type 1 diabetes. Secondary prevention may be possible in children with islet autoimmunity, but the studies are complicated by the variability of glucose metabolism and beta-cell loss.

KW - pediatric diabetes

KW - prevention

KW - Sweden

KW - type 1 diabetes mellitus

UR - http://www.scopus.com/inward/record.url?scp=84978371847&partnerID=8YFLogxK

U2 - 10.1111/pedi.12325

DO - 10.1111/pedi.12325

M3 - Review article

VL - 17

SP - 73

EP - 77

JO - Pediatric Diabetes

JF - Pediatric Diabetes

SN - 1399-543X

IS - S22

ER -