Reviews in Endocrine and Metabolic Disorders

, Volume 7, Issue 3, pp 215–224 | Cite as

Prevention strategies for type 1 diabetes

  • Christopher M. Kishiyama
  • H. Peter Chase
  • Jennifer M. Barker
Article

Abstract

Type 1 diabetes (T1D) is a common chronic disease of childhood. Patients with T1D are at significant risk for developing serious health complications. Understanding of the genetics, environmental factors, and natural history of diabetes has lead to greater understanding of the etiology and epidemiology of T1D. Furthermore, technology has greatly improved glycemic control and reduction of complications. However, prevention of the development of diabetes remains elusive. This review article describes the past, current and upcoming strategies for diabetes prevention for patients at risk for developing autoimmunity, after antibody production, and patients with new onset diabetes.

Keywords

Type 1 diabetes Prevention Genetics Immunology Autoimmunity Therapy 

References

  1. 1.
    Onkamo P, Vaananen S, Karvonen M, Tuomilehto J. Worldwide increase in incidence of type 1 diabetes—the analysis of the data on published incidence trends. Diabetologia 2000;43:1334–6.CrossRefGoogle Scholar
  2. 2.
    Komulainen J, Kulmala P, Savola K, Lounamaa R, Ilonen J, Reijonen H, et al. Clinical, autoimmune, and genetic characteristics of very young children with type 1 diabetes. Childhood diabetes in Finland (DiMe) study group. Diabetes Care 1999;22 12:1950–5 (Dec).PubMedCrossRefGoogle Scholar
  3. 3.
    Kulmala P, Savola K, Reijonen H, Veijola R, Vahasalo P, Karjalainen J, et al. Genetic markers, humoral autoimmunity, and prediction of type 1 diabetes in siblings of affected children. Childhood diabetes in Finland study group. Diabetes 2000;49 1:48–58, Jan.PubMedCrossRefGoogle Scholar
  4. 4.
    EURODIAB ACE Study Group. Lancet 2000;355:873–6.CrossRefGoogle Scholar
  5. 5.
    Pilcher CC, Dickens K, Elliott RB. ICA only develop in early childhood. Diabetes Res Clin Pract 1991;14:S82 (Abstract).Google Scholar
  6. 6.
    Bach J-F. The effect of infections on susceptibility to autoimmune and allergic diseases. N Engl J Med 2002;347:911–20.PubMedCrossRefGoogle Scholar
  7. 7.
    McKinney PA, Okasha M, Parslow RC, Law GR, Gurney KA, Williams R, et al. Early social mixing and childhood type 1 diabetes mellitus: a case-control study in Yorkshire, UK. Diabet Med 2000;17:236–42.PubMedCrossRefGoogle Scholar
  8. 8.
    Hviid A, Stellfeld M, Wohlfahrt J, Melbye M. Childhood vaccination and type 1 diabetes. N Engle J Med 2004;350:1398–404.CrossRefGoogle Scholar
  9. 9.
    Rewers M, Norris J, Kretowski A. Chapter 9: Epidemiology of type 1 diabetes. In: Eisenthbarth GS, editor. Immunology of type 1 diabetes. 2nd ed. Kluwer: Dordrecht; 2005 (Academic/Plenum).Google Scholar
  10. 10.
    Menser MA, Forrest JM, Bransby RD. Rubella infection and diabetes mellitus. Lancet 1978;1:57–60.PubMedCrossRefGoogle Scholar
  11. 11.
    Yoon J-W, Austin M, Onodera T, Notkins AL. Virus-induced diabetes mellitus: isolation of a virus from the pancreas of a child with diabetic ketoacidosis. N Engl J Med 1979;300:1173–9.PubMedCrossRefGoogle Scholar
  12. 12.
    Lonnrot M, Korpela K, Knip M, Ilonen J, Simell O, Korhonen S, et al. Enterovirus infection as a risk factor for β-Cell autoimmunity in a prospectively observed birth cohort. Diabetes 2000;49:1314–8.PubMedCrossRefGoogle Scholar
  13. 13.
    Honeyman MC, Coulson BS, Stone NL, Gellert SA, Goldwater PN, Steele CE, et al. Association between rotavirus infection and pancreatic islet autoimmunity in children at risk of developing type 1 diabetes. Diabetes 2000;49:1319–24.PubMedCrossRefGoogle Scholar
  14. 14.
    Graves PM, Norris JM, Pallansch MA, Gerling IV, Rewers M. The role of enteroviral infections in the development of IDDM. Diabetes 1997;46:161–8.PubMedCrossRefGoogle Scholar
  15. 15.
    Elliott RB, Martin JM. Dietary protein: a trigger of insulin-dependent diabetes in the BB rat? Diabetologia 1984;26:297–9.PubMedCrossRefGoogle Scholar
  16. 16.
    Karges W, Hammond-McKibben D, Cheung RK, Visconti M, Shibuya N, Kemp D, et al. Immunological aspects of nutritional diabetes prevention in NOD mice. A pilot study for the cow’s milk-based IDDM Prevention Trial. Diabetes 1997;46:557–64.PubMedCrossRefGoogle Scholar
  17. 17.
    Gerstein H. Cow’s milk exposure and type 1 diabetes mellitus. Diabetes Care 1994;17:13–9.PubMedCrossRefGoogle Scholar
  18. 18.
    Norris JM, Beaty B, Klingensmith GJ, Yu L, Hoffman M, Chase HP, et al. Lack of association between early exposure to cow’s milk protein and β-cell autoimmunity. JAMA 1996;276:609–14.PubMedCrossRefGoogle Scholar
  19. 19.
    Couper JJ, Steele C, Beresford S, Powell T, McCaul K, Pollard A, et al. Lack of association between duration of breast-feeding or introduction of cow’s milk and development of islet autoimmunity. Diabetes 1999;48:2145–9.PubMedCrossRefGoogle Scholar
  20. 20.
    Paronen J, Knip M, Savilahti E, Virtanen SM, Ilonen J, Akerblom HK, et al. Effect of cow’s milk exposure and maternal type 1 diabetes on cellular and humoral immunization to dietary insulin in infants at genetic risk for type 1 diabetes. Diabetes 2000;49:1657–65.PubMedCrossRefGoogle Scholar
  21. 21.
    Ziegler A-G, Hummel M, Sckenker M, Bonifacio E. Autoantibody appearance and risk for development of childhood diabetes in offspring of parents with type 1 diabetes: the 2-year analysis of the German BABYDIAB study. Diabetes 1999;48:460–8.PubMedCrossRefGoogle Scholar
  22. 22.
    Simopoulos AP. Essential fatty acids in health and chronic disease. Am J Clin Nutr 1999;70:560S–9S.PubMedGoogle Scholar
  23. 23.
    Stene LC, Ulriksen J, Magnus P, Joner G. Use of cod liver oil during pregnancy associated with lower risk of Type I diabetes in the offspring. Diabetologia 2000;43:1093–8.PubMedCrossRefGoogle Scholar
  24. 24.
    Stene LC, Joner G, the Norwegian Childhood Diabetes Study Group. Use of cod liver oil in the first year of life associated with lower risk of childhood onset type 1 diabetes: a large population based case-control study. Am J Clin Nutr 2003;78:1128–34.PubMedGoogle Scholar
  25. 25.
    Joner G. The epidemiology of insulin-dependent diabetes mellitus in Norway: incidence, prevalence, microvascular complications and mortality (Thesis). Oslo: Haukeland University Hospital and Aker University Hospital; 1992.Google Scholar
  26. 26.
    Decsi T, Minda H, Hermann R, Kozári A, Erhardt E, Burus I, et al. Polyunsaturated fatty acids in plasma and erythrocyte membrane lipids of diabetic children. Prostaglandins Leukot Essent Fat Acids 2002;67:203–10.CrossRefGoogle Scholar
  27. 27.
    Endres S, Ghorbani R, Kelley VE, Georgilis K, Lonnemann G, van der eer JW, et al. The effect of dietary supplementation with n-3 polyunsaturated fatty acids on the synthesis of interleukin-1 and tumor necrosis factor by mononuclear cells. N Engl J Med 1989;320:265–71.PubMedCrossRefGoogle Scholar
  28. 28.
    Chase HP, Williams RL, Dupont J. Increased prostaglandin synthesis in childhood diabetes mellitus. J Pediatr 1979;94:185–9.PubMedCrossRefGoogle Scholar
  29. 29.
    Litherland SA, She JX, Schatz D, Fuller K, Hutson AD, Peng RH, et al. Aberrant monocyte prostaglandin synthase 2 (PGS2) expression in type 1 diabetes before and after disease onset. Pediatr Diabetes 2003;4 1:10–8.PubMedCrossRefGoogle Scholar
  30. 30.
    Halminen M, Simell O, Knip M, Ilonen J. Cytokine expression in unstimulated PBMC of children with type 1 diabetes and subjects positive for diabetes-associated autoantibodies. Scand J Immunol 2001;53:510–3.PubMedCrossRefGoogle Scholar
  31. 31.
    Chase HP, Cooper S, Osberg I, Stene LC, Barriga K, Norris J, et al. Elevated C-Reactive protein levels in the development of type 1 diabetes. Diabetes 2004;53:2569–73.PubMedCrossRefGoogle Scholar
  32. 32.
    McGregor JA, Allen KG, Harris MA, Reece M, Wheeler M, French JI, et al. The omega-3 story: nutritional prevention of preterm birth and other adverse pregnancy outcomes. Obstet Gynecol Surv 2001;56 5 Suppl 1:S1–13.PubMedCrossRefGoogle Scholar
  33. 33.
    Christensen OB, Hindsen M, Svensson A. Natural history of dermatitis herpetiformis in southern Sweden. Dermatologica 1986;173:271–7.PubMedCrossRefGoogle Scholar
  34. 34.
    DPT-1 Study Group. The diabetes prevention trial-type 1 diabetes (DPT-1): implementation of screening and staging of relatives. Transplant Proc 1995;27:3377.Google Scholar
  35. 35.
    Rewers M, LaPorte RE, King H, Tuomilehto J. Trends in the prevalence and incidence of diabetes: insulin-dependent diabetes mellitus in childhood. World Health Stat Q 1985;41:179–89.Google Scholar
  36. 36.
    Patrick SL, Moy CS, LaPorte RE. The world of IDDM: what international epidemiologic studies reveal about the etiology and natural history of IDDM. Diabetes/Metab Rev 1989;5:571–8.CrossRefGoogle Scholar
  37. 37.
    Steck AK, Barriga KJ, Emery LM, Fiallo-Scharer RV, Gottlieb PA, Rewers MJ. Secondary attack rate of type 1 diabetes in Colorado families. Diabetes Care 2005;28:296–300.PubMedCrossRefGoogle Scholar
  38. 38.
    Zhang ZJ, Davidson L, Eisenbarth G, Weiner HL. Suppression of diabetes in nonobese diabetic mice by oral administration of porcine insulin. Proc Natl Acad Sci USA 1991;88:10252–6.PubMedCrossRefGoogle Scholar
  39. 39.
    Daniel D, Wegmann DR. Protection of nonobese diabetic mice from diabetes by intranasal or subcutaneous administration of insulin peptide B-(9–23). Proc Natl Acad Sci U S A 1996;93:956–60.PubMedCrossRefGoogle Scholar
  40. 40.
    Effects of insulin in relatives of patients with type 1 diabetes mellitus. N Engl J Med 2002;346:1685–91.Google Scholar
  41. 41.
    Diabetes Prevention Trial—Type 1 Study Group[Gitelman SE—Study Group Member]. Effects of oral insulin in relatives of patients with type 1 diabetes: the diabetes prevention trial-type 1. Diabetes Care 2005;28:1068–76.Google Scholar
  42. 42.
    Pociot F, ReimersJI, Andersen HU. Nicotinamide—biological actions and therapeutic potential in diabetes prevention. Diabetologia 1993;36:574–6.PubMedCrossRefGoogle Scholar
  43. 43.
    Pozzilli P, Visalli N, Ghirlanda G, Manna R, Andreani D. Nicotinamide increases C-peptide secretion in patients with recent onset type 1 diabetes. Diabet Med 1989;6:568–72.PubMedCrossRefGoogle Scholar
  44. 44.
    Gale EA, Bingley PJ, Emmett CL, Collier T. European nicotinamide diabetes intervention trial (ENDIT): a randomised controlled trial of intervention before the onset of type 1 diabetes. Lancet 2004;363:925–31.PubMedCrossRefGoogle Scholar
  45. 45.
    Gepts W. Pathologica anatomy of the pancreas in juvenile diabetes mellitus. Diabetes 1965;14:619–33.PubMedGoogle Scholar
  46. 46.
    Group TDC. Effect of intensive therapy on residual beta-cell function in patients with type 1 diabetes in the diabetes control and complications trial: a randomized controlled trial. Ann Intern Med 1998;128:517–23.Google Scholar
  47. 47.
    Palmer JP, Fleming GA, Greenbaum CJ, Herold KC, Jansa LD, Kolb H, et al. C-peptide is the appropriate outcome measure for type 1 diabetes clinical trials to preserve beta cell function: report of an ADA workship, 21–22 October 2001. Diabetes 2004;51:2126–34.Google Scholar
  48. 48.
    Herold KC, Lancki DW, Moldwin RL, Fitch FW. Immunosuppressive effects of cyclosporine A on cloned T cells. J Immunol 1986;136:1315–21.PubMedGoogle Scholar
  49. 49.
    Rabinovich A. An update on cytokines in the pathogenesis of insulin-depended diabetes mellitus. Diabetes/Metab Rev 1998;14:129–51.CrossRefGoogle Scholar
  50. 50.
    Stiller CR, Dupre J, Gent M, Jenner M, Keown PA, Laupacis A, et al. Effects of cyclosporine immunosuppression in insulin-dependent diabetes mellutis of recent onset. Science 1984;223:1362–7.PubMedCrossRefGoogle Scholar
  51. 51.
    Bougneres PF, Carel JC, Castano L, Boitard C, Gardin JP, Landais P, et al. Factors associated with early remission of type I diabetes in children treated with cyclosporine. N Engl J Med 1988;318:663–70.PubMedCrossRefGoogle Scholar
  52. 52.
    Parving HH, Tarnow L, Nielsen FS, Rossing P, Mandrup-Poulsen T, Osterby R, et al. Cyclosporine nephrotoxicity in type 1 diabetic patients. A 7-year follow-up study. Diabetes Care 1999;22:478–83.PubMedCrossRefGoogle Scholar
  53. 53.
    Silverstein J, Maclaren N, Riley W, Spillar R, Radjenovic D, Johnson S. Immunosuppression with azathioprine and prednisone in recent-onset insulin-dependent diabetes mellitus. N Engl J Med 1988;319:599–604.PubMedCrossRefGoogle Scholar
  54. 54.
    Eisenbarth GS, Srikanta S, Jackson R, Rabinowe S, Dolinar R, Aoki T, et al. Anti-thymocyte globulin and prednisone immunotherapy of recent onset type 1 diabetes mellitus. Diabetes Res 1985;2:271–6.PubMedGoogle Scholar
  55. 55.
    Chatenoud L. OKT3-induced cytokine-release syndrome: prevention effect of anti-tumor necrosis factor monoclonal antibody. Transplant Proc 1993;25:47–51.PubMedGoogle Scholar
  56. 56.
    Chatenoud L, Bach JF. Anti-CD3 antibodies. Immunol Ser 1993;59:175–91.PubMedGoogle Scholar
  57. 57.
    Herold KC, Hagopian W, Auger JA, Poumian-Ruiz E, Taylor L, Donaldson D, et al. Anti-CD3 monoclonal antibody in new-onset type 1 diabetes mellitus. N Engl J Med 2002;346:1692–8, May 30.PubMedCrossRefGoogle Scholar
  58. 58.
    Chase HP, Hayward AR, Eisenbarth GS. Chapter 12, Clinical trials for the prevention of type I diabetes. In: Type I diabetes: molecular, cellular, and clinical immunology.Google Scholar
  59. 59.
    Qin HY, Sadelain MW, Hitchon C, Lauzon J, Singh B. Complete Freund’s adjuvant-induced T cells prevent the development and adoptive transfer of diabetes in nonobese diabetic mice. J Immunol 1993;150:2072–80 (Mar 1).PubMedGoogle Scholar
  60. 60.
    Qin HY, Singh B. BCG vaccination prevents insulin-dependent diabetes mellitus (IDDM) in NOD mice after disease acceleration with cyclophosphamide. J Autoimmun 1997;10:271–8 (Jun).PubMedCrossRefGoogle Scholar
  61. 61.
    Elias D, Prigozin H, Polak N, Rapoport M, Lohse AW, Cohen IR. Autoimmune diabetes induced by the beta-cell toxin STZ. Immunity to the 60-kDa heat shock protein and to insulin. Diabetes 1994;43:992–8.PubMedCrossRefGoogle Scholar
  62. 62.
    Elias D, Cohen IR. Peptide therapy for diabetes in NOD mice. Lancet 1944;343:704–6.CrossRefGoogle Scholar
  63. 63.
    Elias D, Reshef T, Birk OS, van der Zee R, Walker MD, Cohen IR. Vaccination against autoimmune mouse diabetes with a T-cell epitope of the human 65-kDa heat shock protein. Proc Natl Acad Sci U S A 199;88:3088–91.PubMedCrossRefGoogle Scholar
  64. 64.
    Raz I, Elias D, Avron A, Tamir M, Metzger M, Cohen IR. Beta-cell function in new-onset type 1 diabetes and immunomodulation with a heat-shock protein peptide (DiaPep277): a randomised, double-blind, phase II trial. Lancet 2001;358 24:1749–53.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2006

Authors and Affiliations

  • Christopher M. Kishiyama
    • 1
  • H. Peter Chase
    • 1
  • Jennifer M. Barker
    • 1
  1. 1.The Barbara Davis Center for Childhood DiabetesDenverUSA

Personalised recommendations