Advertisement

Acta Diabetologica

, Volume 55, Issue 2, pp 117–120 | Cite as

The shifting paradigm of a “cure” for type 1 diabetes: is technology replacing immune-based therapies?

  • Jeremy PettusEmail author
  • Matthias Von Herrath
Perspectives

Abstract

Nearly 50 years after the autoimmune nature of type 1 diabetes was discovered, no therapy has been approved to alter the course of the disease at any stage. However, during that same period, technology has been delivering tools to help patients achieve better glycemic control and reduce the burden of the disease. With the imminent arrival of fully automated artificial pancreas systems that will continue to improve control and quality of life, it appears that we are on the verge of a major technological breakthrough that will significantly impact diabetes care. These devices have such a high degree of potential that they are, at times, mentioned as a virtual cure for the disease—a first for technology in this space. As such, these devices will undoubtedly alter the research landscape in a field that has predominantly been occupied by immunotherapies. This article reviews the history of type 1 diabetes and compares and contrasts the advancements that have come from the world of technology and immunology alike at this important crossroads in care that we are currently in.

Keywords

Type 1 diabetes Artificial pancreas Immunotherapies 

Notes

Compliance with ethical standards

Conflict of interest

J Pettus was a consultant for Novo Nordisk, Sanofi, Mannkind, Insulet. He received research support from JDRF, Viacyte. M. Von Herrath was an employee for Novo Nordisk.

Human and animal rights statement

This article does not contain any studies with human or animal subjects performed by the any of the authors.

References

  1. 1.
    Bottazzo GF, Florin-Christensen A, Doniach D (1974) Islet-cell antibodies in diabetes mellitus with autoimmune polyendocrine deficiencies. Lancet 2(7892):1279–1283CrossRefPubMedGoogle Scholar
  2. 2.
    Stiller CR et al (1984) Effects of cyclosporine immunosuppression in insulin-dependent diabetes mellitus of recent onset. Science 223(4643):1362–1367CrossRefPubMedGoogle Scholar
  3. 3.
    Polonsky KS (2012) The past 200 years in diabetes. N Engl J Med 367(14):1332–1340CrossRefPubMedGoogle Scholar
  4. 4.
    Ludvigsson J et al (2012) GAD65 antigen therapy in recently diagnosed type 1 diabetes mellitus. N Engl J Med 366(5):433–442CrossRefPubMedGoogle Scholar
  5. 5.
    Voltarelli JC et al (2007) Autologous nonmyeloablative hematopoietic stem cell transplantation in newly diagnosed type 1 diabetes mellitus. JAMA 297(14):1568–1576CrossRefPubMedGoogle Scholar
  6. 6.
    Garyu JW et al (2016) Progress and challenges for treating type 1 diabetes. J Autoimmun 71:1–9CrossRefPubMedPubMedCentralGoogle Scholar
  7. 7.
    Sherry N et al (2011) Teplizumab for treatment of type 1 diabetes (protege study): 1-year results from a randomised, placebo-controlled trial. Lancet 378(9790):487–497CrossRefPubMedPubMedCentralGoogle Scholar
  8. 8.
    Faustman DL (2013) EBV infection and anti-CD3 treatment for Type 1 diabetes: bad cop, good cop? Expert Rev Clin Immunol 9(2):95–97CrossRefPubMedPubMedCentralGoogle Scholar
  9. 9.
    Bergenstal RM et al (2016) Safety of a hybrid closed-loop insulin delivery system in patients with type 1 diabetes. JAMA 316(13):1407–1408CrossRefPubMedGoogle Scholar
  10. 10.
    Russell SJ et al (2014) Outpatient glycemic control with a bionic pancreas in type 1 diabetes. N Engl J Med 371(4):313–325CrossRefPubMedPubMedCentralGoogle Scholar
  11. 11.
    Fisher L et al (2015) Understanding the sources of diabetes distress in adults with type 1 diabetes. J Diabetes Complicat 29(4):572–577CrossRefPubMedPubMedCentralGoogle Scholar

Copyright information

© Springer-Verlag Italia S.r.l. 2017, part of Springer Nature (outside the USA) 2017

Authors and Affiliations

  1. 1.Department of MedicineUniversity of California, San DiegoSan DiegoUSA
  2. 2.Type 1 Diabetes CenterLa Jolla Institute for Allergy and ImmunologyLa JollaUSA
  3. 3.Novo Nordisk Diabetes Research and Development CenterSeattleUSA
  4. 4.Clinical and Translational Research InstituteUniversity of California, San DiegoLa JollaUSA

Personalised recommendations