Prevention of type 1 diabetes: today and tomorrow

Diabetes Metab Res Rev. 2010 Nov;26(8):602-5. doi: 10.1002/dmrr.1138. Epub 2010 Oct 8.


The aim of therapeutic interventions for type 1 diabetes is to suppress pathogenic autoreactivity and to preserve/restore beta-cell mass and function to physiologically sufficient levels to maintain good metabolic control. During the natural history of type 1 diabetes, several strategies have been applied at various stages in the form of primary, secondary or tertiary prevention approaches. Clinical trials using antigen-specific (e.g. DiaPep277, human glutamic acid decarboxylase 65 (GAD65)) or non-specific immune therapies (e.g. anti-CD3 monoclonal antibodies) have shown some benefit in the modulation of the autoimmune process and prevention of the insulin secretion loss in the short term after diagnosis of diabetes. A single long-term effective therapy has not been identified yet, and it is likely that in most cases a rationally designed combinatorial approach using immunotherapeutic methods coupled with islet regeneration or replacement will prove to be most effective.

MeSH terms

  • Administration, Intranasal
  • Adult
  • Antigens, CD20 / immunology
  • CD3 Complex / immunology
  • Child
  • Clinical Trials as Topic
  • Diabetes Mellitus, Type 1 / immunology
  • Diabetes Mellitus, Type 1 / prevention & control*
  • Drug Therapy, Combination
  • Glutamate Decarboxylase / therapeutic use
  • Humans
  • Insulin / administration & dosage


  • Antigens, CD20
  • CD3 Complex
  • Insulin
  • Glutamate Decarboxylase