Factors impeding the discovery of an intervention‐based treatment for type 1 diabetes

Summary Type 1 diabetes (T1D) is one of the most common and severe chronic diseases affecting both children and adults. The aetiology of the disease remains unknown, and thus far no ‘true’ cure for those affected is available. Indeed, exogenous insulin replacement therapy to manage glucose metabolis...

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Veröffentlicht in:Clinical and experimental immunology Jg. 183; H. 1; S. 1 - 7
Hauptverfasser: von Herrath, M. G., Korsgren, O., Atkinson, M. A.
Format: Journal Article
Sprache:Englisch
Veröffentlicht: England Oxford University Press 01.01.2016
John Wiley and Sons Inc
Schlagworte:
Adult
Animals
autoimmune disease
beta cells
Blood Glucose - metabolism
Child
Diabetes Mellitus, Type 1 - therapy
Humans
Hypoglycemic Agents - therapeutic use
immune therapy
insulin
Insulin - therapeutic use
Pancreas - metabolism
Pancreas - pathology
Translational Research, Biomedical
type 1 diabetes
Type 1 Diabetes Mini‐series: Pathogenesis and Therapy
immune therapy
type 1 diabetes
insulin
autoimmune disease
beta cells
ISSN:0009-9104, 1365-2249, 1365-2249
Online-Zugang:Volltext
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Zusammenfassung:Summary Type 1 diabetes (T1D) is one of the most common and severe chronic diseases affecting both children and adults. The aetiology of the disease remains unknown, and thus far no ‘true’ cure for those affected is available. Indeed, exogenous insulin replacement therapy to manage glucose metabolism to the best degree possible remains the current standard of care. However, despite a recent array of truly impressive improvements designed to enhance disease management (e.g. insulin analogues, continuous glucose monitoring, insulin pumps), it is still difficult for the vast majority of patients to reach recommended target HbA1C levels (< 7·0%). As a result of suboptimal disease management, far too many patients with T1D have an increased risk for disease‐associated complications such as nephropathy, neuropathy and retinopathy, as well as hypoglycaemia. New treatment modalities are therefore needed urgently to bring a ‘true’ cure (disease prevention/disease reversal) to patients with T1D. Here we consider issues that collectively pose a major stumbling block in T1D research with respect to identifying a means to prevent and/or cure the disease. We begin this Perspective by discussing new insights emanating from studies of the pancreas in human T1D; findings which may, at least in part, explain why previous interventions seeking disease prevention/reversal have yielded insufficient benefit. We then turn to suggestions that could optimise the outcome of future clinical trials. Finally, we direct attention to recommendations for the global T1D research community; messages we deem to have the potential to improve our chances of finding the elusive T1D ‘cure’.
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ISSN:0009-9104
1365-2249
1365-2249
DOI:10.1111/cei.12656