Preventing type 1 diabetes in childhood

Science. 2021 Jul 30;373(6554):506-510. doi: 10.1126/science.abi4742.


Type 1 diabetes (T1D) is an autoimmune disease in which the insulin-producing β cells of the pancreas are destroyed by T lymphocytes. Recent studies have demonstrated that monitoring for pancreatic islet autoantibodies, combined with genetic risk assessment, can identify most children who will develop T1D when they still have sufficient β cell function to control glucose concentrations without the need for insulin. In addition, there has been recent success in secondary prevention using immunotherapy to delay the progression of preclinical disease, and primary prevention approaches to inhibiting the initiating autoimmune process have entered large-scale clinical trials. By changing the focus of T1D management from late diagnosis and insulin replacement to early diagnosis and β cell preservation, we can anticipate a future without the need for daily insulin injections for children with T1D.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Autoantibodies / blood
  • Biomarkers / blood
  • Child
  • Diabetes Mellitus, Type 1 / diagnosis
  • Diabetes Mellitus, Type 1 / genetics
  • Diabetes Mellitus, Type 1 / prevention & control*
  • Diabetes Mellitus, Type 1 / therapy
  • Disease Progression
  • Early Diagnosis
  • Genetic Predisposition to Disease
  • Genetic Testing
  • Humans
  • Insulin / therapeutic use
  • Insulin-Secreting Cells / physiology
  • Islets of Langerhans / immunology
  • Primary Prevention
  • Secondary Prevention


  • Autoantibodies
  • Biomarkers
  • Insulin
  • islet cell antibody