Prevention of Type 1 Diabetes

Abstract

There is a genetic predisposition to type 1 diabetes (T1D), particularly conferred by alleles present within the major histocompatibility complex. In susceptible individuals, an environmental trigger initiates an immune response. The immune infiltration into pancreatic islets results in beta cell damage, impairment of beta cell function, and potential destruction of beta cells. Consequently, there have been a number of studies using immune intervention in an attempt to alter the natural history of the disease. These studies have been conducted both before clinical manifestations of T1D, in an attempt to prevent the evolution of the disease, and after the clinical onset of T1D, in an attempt to slow progressive loss of beta cell function. This chapter summarizes the most important clinical trials that have been conducted to date.