Sunday, April 29, 2012
Can type 1 diabetes also be prevented?
At the present time, we do not think that type 1 dia- betes can effectively be prevented. Part of the problem is that we do not know the exact environmental trig- ger(s), although there is provocative evidence for a number of factors, such as early exposure to cow’s milk, certain viral strains, and lack of stimulation of the immune system at an early age by natural exposure to infective agents. The evidence is insufficient to make specific recommendations for avoidance of, or immunization against, specific potential triggering agents. A number of clinical trials of agents that modify the immune system attack on the insulin- producing cells of the pancreas (see Question 2) are under way. In general, these agents cause a number of side effects. Trials are focused on patients with newly diagnosed diabetes, to determine whether very early diabetes can be reversed, before their use in people without symptoms who are at an increased risk of development of the disease can be justified. There is also a significant genetic (hereditary) component of risk for type 1 diabetes (see Question 7) that can presently not be modified. First, therapies based on genetic modification in general are still at a very early stage of development. Second, the exact gene or genes that require modification are not conclusively known.