Type 1 Diabetes TrialNet: working together to prevent, delay or slow the progression of type 1 diabetes

摘要

Over the last 30 years, we have learnt a great deal about the processes that culminate in the clinical onset of type 1 diabetes (T1DM). We know that beta cells in the islets are targets of selective autoimmunity, and that autoimmunity -in the form of circulating islet autoantibodies - can be detected many years before clinical onset of diabetes and generally starts in infancy.1 We are now able accurately to identify individuals at increased risk of T1DM, both among relatives of people with diabetes and children in the general population who are at high genetic risk.2 We also know that the beta cells are destroyed by cell-mediated immunity. With these insights comes the possibility that we might be able to intervene to alter these processes - to slow or perhaps ultimately prevent the clinical onset of disease.