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Expert Position Statement
Strategies for the prevention of autoimmune Type 1 diabetes
Version of Record online: 19 SEP 2011
© 2011 The Authors. Diabetic Medicine © 2011 Diabetes UK
Volume 28, Issue 10, pages 1141–1143, October 2011
How to Cite
Todd, J. A., Knip, M. and Mathieu, C. (2011), Strategies for the prevention of autoimmune Type 1 diabetes. Diabetic Medicine, 28: 1141–1143. doi: 10.1111/j.1464-5491.2011.03400.x
- Issue online: 19 SEP 2011
- Version of Record online: 19 SEP 2011
- Accepted manuscript online: 3 AUG 2011 04:33PM EST
- Accepted 29 July 2011
Diabet. Med. 28, 1141–1143 (2011)
European experts on autoimmune Type 1 diabetes met for 2 days in October 2010 in Cambridge, to review the state-of-the-art and to discuss strategies for prevention of Type 1 diabetes (http://www-gene.cimr.cam.ac.uk/todd/sub_pages/T1D_prevention_Cambridge_workshop_20_21Oct2010.pdf). Meeting sessions examined the epidemiology of Type 1 diabetes; possible underlying causes of the continuing and rapid increase in Type 1 diabetes incidence at younger ages; and lessons learned from previous prevention trials. Consensus recommendations from the meeting were:
1. Resources such as national diabetes registries and natural history studies play an essential role in developing and refining assays to be used in screening for risk factors for Type 1 diabetes.
2. It is crucial to dissect out the earliest physiological events after birth, which are controlled by the susceptibility genes now identified in Type 1 diabetes, and the environmental factors that might affect these phenotypes, in order to bring forward a mechanistic approach to designing future prevention trials.
3. Current interventions at later stages of disease, such as in newly diagnosed Type 1 diabetes, have relied mainly on non-antigen-specific mechanisms. For primary prevention—preventing the onset of autoimmunity—interventions must be based on knowledge of the actual disease process such that: participants in a trial would be stratified according the disease-associated molecular phenotypes; the autoantigen(s) and immune responses to them; and the manipulation of the environment, as early as possible in life. Combinations of interventions should be considered as they may allow targeting different components of disease, thus lowering side effects while increasing efficacy.