Science has learned much about Type 1 diabetes in recent years. This knowledge is being applied in several ways to identify the underlying causes of and ways to prevent diabetes. Here are several examples.
Type 1 Diabetes TrialNet is a group of studies looking at the prevention and early treatment of type 1 diabetes. Current studies include:
- The Natural History Study of the Development of Type 1 Diabetes will study people at increased risk for type 1 diabetes to learn more about how type 1 diabetes occurs.
- The MMF/DZB Study will see if it is possible to stop the immune system from destroying beta cells in new onset type 1 diabetes patients (within 3 months of diagnosis).
For more information, see the TrialNet brochure (PDF format).
The Diabetes Autoimmunity Study in the Young (DAISY) is an investigation into the environmental causes of the autoimmunity associated with Type 1 diabetes. It is being conducted at the University of Colorado School of Medicine in conjunction with the Barbara Davis Center for Childhood Diabetes in Denver, Colorado.
The study focuses on children from birth through age 3 who are at high risk for developing Type 1 diabetes because of their genetic predisposition. Children are screened for the genetic markers that indicate high risk. Saliva samples and viral cultures (from mouth and rectal swabs) will also be taken. Parents fill out detailed questionnaires about events that occurred during the life of the child. The researchers will follow the child during additional clinical visits. Proximity to Denver, Colorado, or willingness to travel to Denver, is highly desired.
For more information about the DAISY study, contact contact Michelle Hoffman, RN, at
Diabetes Autoimmunity Study in the Young
University of Colorado School of Medicine
4200 East Ninth Avenue
Denver, CO 80262
The Trial to Reduce Insulin-Dependent Diabetes in the Genetically at Risk (TRIGR) will help determine whether delayed exposure to intact food proteins will reduce the chances of developing type 1 diabetes later in life. All babies in the study receive the recommendation to breastfeed for at least the first six months of life. If a mother is unable to breastfeed exclusively before the baby is 8 months of age, her child will be randomly assigned to one of two groups. One group of these babies will receive breastfeeding supplements of a trial formula based on extensively hydrolyzed protein; the other group will receive a special trial formula containing a smaller amount of hydrolyzed protein. In hydrolyzed protein, the big protein molecules have been split into very small fragments to provide a source of nutritional amino acids, but the fragments are likely too small to stimulate the immune system.
TRIGR is seeking participants in the United States, Canada, Europe, and Australia. For more information, see the TRIGR web site
ENDIT is a multicenter study underway in Europe, Canada, and Israel to test the possible preventive effect of nicotinamide in Type 1 diabetes. From an early report on the study:
Type 1 diabetes "is caused by an immune-mediated destruction of the insulin-producing beta cells. Beta cells are destroyed by induction of oxygen-derived free radicals (FR) and nitric oxide (NO), which results in perturbation of the mitochondrial respiratory system and DNA strand breaks. As a result of beta cell destruction, islet cell antibodies (ICA) can be demonstrated in the circulation. These antibodies can be detected up to eight years prior to overt IDDM. Nicotinamide, a vitamin B3 derivative, interferes with the immune mediated beta-cell destruction by reducing the content of FR and NO and thereby reducing their deleterious effects. At the same time, nicotinamide increases the intracellular NAD pool, thus increasing the energy supply of the cell. Nicotinamide protects against chemically induced as well as spontaneous diabetes in animal models of the disease."
For More Information
- The following articles from the ISPAD web site are published in PDF format and require the Adobe Acrobat Reader to read:
- Psychological Aspects in Diabetes Prevention Trials by Bruno Weber and Roswith Roth. Ann Med 1997;29:461467. (75 kB)
- From Pathomechanisms to Prediction, Prevention and Improved Care of Insulin-dependent Diabetes Mellitus in Children by Hans K. ┼kerblom, Mikael Knip, and Olli Simell. Ann Med 1997;29:383-85. (43 kB)
- Strategies for Identifying and Predicting Islet Autoantigen T-cell Epitopes in Insulin-dependent Diabetes Mellitus by Margo C. Honeyman, Vladimir Brusic, and Leonard C. Harrison. Ann Med 1997;29:401-404. (66 kB)
- Islet Cell Antigens in the Prediction and Prevention of Insulin-dependent Diabetes Mellitus by Ezio Bonifacio and Michael R. Christie. Ann Med 1997;29:405-12. (88 kB)
- Viruses and Other Perinatal Exposures as Initiating Events for b-cell Destruction by Gisela G. Dahlquist. Ann Med 1997;29:413-17. (63 kB)
- Disease-associated Autoimmunity and Prevention of Insulin-dependent Diabetes Mellitus by Michael Knip. Ann Med 1997;29:447-51. (238 kB)
- Antibody Screening in a Population of Children by Manou R. Batstra, G. Jan Bruining, and Henk-Jan Aanstoot. Ann Med 1997;29:453-460. (522 kB)
- Research News and Information
- Research News from the Juvenile Diabetes Foundation
- Diabetes Research Institute
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