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  cows 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.

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