Ask The Expert
Education, Care & Research

Yes! There are many exciting and promising studies currently underway to determine the best way to prevent or delay the onset of type 1 diabetes.

I will provide an overview but you can read more details in the related links below about research that is being done through both JDRF (the Juvenile Diabetes Research Foundation) and TrialNet, which is a network of 18 Clinical Centers working in cooperation with screening sites throughout the United States, Canada, Finland, United Kingdom, Italy, Germany, Australia, and New Zealand. This network is dedicated to the study, prevention, and early treatment of type 1 diabetes.

• TrialNet is supported by the United States National Institutes of Health and Department of Health & Human Services, Juvenile Diabetes Research Foundation International, and the American Diabetes Association.
  

A brief summary of the development of Type 1

• There is a genetic predisposition
• An environmental trigger (which could even be in utero) starts the autoimmune process
• This causes injury to the beta cells, resulting in insulitis (inflammation of the beta cells)
• The body develops antibodies reflecting the injury to the beta cells-these antibodies (such as ICA, IAA, GAD) can be measured
• There is a loss of the first phase insulin release
  • Insulin is normally released in 2 phases: the first-phase occurs in 2-4 minutes and lasts about 10 minutes; this is followed by a sustained secretion of insulin, called the second-phase insulin release, which plateaus at 2-3 hours.
• Glucose intolerance develops, and progresses to the overt clinical onset of diabetes
  

How and when to intervene

Preventative treatments are possible at all of the above stages during the development of diabetes, and the challenge is always to attain a balance between the possible benefits, safety, and the potential risks.

Types of studies

• Natural History Studies provide information about risk factors associated with developing type 1 diabetes.
  • Research is done in relatives of people with type 1 diabetes because they are at greater risk for developing the disease.
  • TrialNet is screening relatives of people with type 1 diabetes to see if these family members are at risk for developing type 1 diabetes. Screening involves a simple blood test to look for diabetes-related autoantibodies that may appear years before type 1 diabetes develops.
  • Studies are looking at what causes type 1 diabetes and what might predict the development of this disease. These studies provide close monitoring to individuals at risk for developing type 1 diabetes. Those at greater risk may be offered an opportunity to participate in a prevention study.
  • Studies include studying pregnant women for predisposition of diabetes in their babies, and then investigating: if cow's milk is an environmental trigger; use of oral or nasal insulin before antibodies appear; delaying the exposure to gluten in a baby's diet; use of certain vitamins.
• Diabetes Intervention Studies test either treatments to delay or prevent the onset of type 1 diabetes, or test treatments to preserve remaining insulin secretion in people recently diagnosed with type 1 diabetes. If even a little insulin production is preserved, this might help make the disease easier to treat.
  • There are a number of complex studies being done, including use of immunosuppressors, antigen specific therapy, nutritional therapy, and certain experimental vaccines.
• There is an exciting amount of research being done, and I encourage you to read more in the links below, as well as to consider signing up for regular e-news updates you can read about in the related question on how to stay current in diabetes and research.