Prevention and Reversal of Type 1 Diabetes--Past Challenges and Future Opportunities

Diabetes Care. 2015 Jun;38(6):997-1007. doi: 10.2337/dc15-0349.

Abstract

Over the past three decades there have been a number of clinical trials directed at interdicting the type 1 diabetes (T1D) disease process in an attempt to prevent the development of the disease in those at increased risk or to stabilize-potentially even reverse-the disease in people with T1D, usually of recent onset. Unfortunately, to date there has been no prevention trial that has resulted in delay or prevention of T1D. And, trials in people with T1D have had mixed results with some showing promise with at least transient improvement in β-cell function compared with randomized control groups, while others have failed to slow the decline in β-cell function when compared with placebo. This Perspective will assess the past and present challenges in this effort and provide an outline for potential future opportunities.

MeSH terms

  • Alum Compounds / therapeutic use
  • Animals
  • Antibodies, Monoclonal, Humanized / therapeutic use
  • Antigens / therapeutic use
  • Antilymphocyte Serum / therapeutic use
  • BCG Vaccine / therapeutic use
  • Chaperonin 60 / therapeutic use
  • Diabetes Mellitus, Type 1 / physiopathology
  • Diabetes Mellitus, Type 1 / prevention & control*
  • Forecasting
  • Glucagon-Like Peptide 1 / therapeutic use
  • Humans
  • Hypoglycemic Agents / therapeutic use
  • Insulin-Secreting Cells / physiology
  • Interleukin-2 / therapeutic use
  • Mice
  • Peptide Fragments / therapeutic use
  • Pilot Projects
  • Randomized Controlled Trials as Topic
  • Research Design
  • Treatment Outcome

Substances

  • Alum Compounds
  • Antibodies, Monoclonal, Humanized
  • Antigens
  • Antilymphocyte Serum
  • BCG Vaccine
  • Chaperonin 60
  • DiaPep 277
  • Hypoglycemic Agents
  • Interleukin-2
  • Peptide Fragments
  • Glucagon-Like Peptide 1
  • thymoglobulin
  • otelixizumab
  • teplizumab