Prevention is Better than Cure

Type 1 Diabetes Prevention

If you don’t smoke cigarettes, you greatly decrease your risk for lung cancer and emphysema. If you keep a healthy weight, eat a moderate diet, and get regular workout, you considerably increase the chance that you’ll have a healthy heart.

But if you’re at risk for developing type 1 diabetes due to a household history of the disease or other aspects, exists anything you can do to stop it? The answer is a certain “possibly.”

Is It Really Possible to Prevent Type 1 Diabetes?

Diabetes experts now acknowledge that type 1 diabetes is an autoimmune disease, in which the body’s body immune system for some factor switches on itself and starts to attack and damage the beta- islet cells of the pancreas that produce and launch insulin. When enough beta islets are ruined, the body can not produce sufficient insulin to correctly control blood glucose, leading to type 1 diabetes.

Due to the fact that type 1 diabetes is brought on by a normal body immune system gone awry, scientists think that it might be possible to action in and either avoid, disrupt, or a minimum of decrease the disease-development procedure. Outcome so far, however, have been mixed at best.

Diabetes Prevention Trial – type 1

The biggest and most enthusiastic avoidance trial performed to this day is the Diabetes Prevention Trial – type 1 (DPT-1), begun in 1994. The study was developed to figure out if it is possible to prevent or postpone the beginning of type 1 diabetes in individuals who are at risk for developing the disease. The theory behind the trial was that by receiving low-doses of insulin over a sustained period, the immune system could discover how to end up being “tolerant” to insulin and therefore leave the insulin-producing beta-islet cells alone.

After a preliminary screening, patients were appointed, relying on their level of risk (based on family history and genetic profiles), to one of two trial arms:

  • The insulin injection trial (finished). Individuals who were identified to be at high risk of developing type 1 diabetes within five years were randomly assigned to either a treatment group or control (unattended) group. The treatment group got twice-daily injections of low-dose, long-acting insulin, plus a once-a-year, five-day treatment of intravenous insulin infusion. Sadly, this arm of the trial proved to be a bust, with 60% of patients in both the dealt with and without treatment groups going on to establish type 1 diabetes.
  • Oral antigen trial. This, the second arm of DPT-1, involved participants at intermediate risk (25-50%) of establishing type 1 diabetes within 5 years who are randomly appointed to get either oral insulin or a placebo (dummy pill). “This arm of the trial is based upon an entirely various hypothesis [than the injection arm],” says diabetes professional John Dupre, FRCP, MA, professor of medication at the University of Western Ontario in London, Ontario. “There is a very possible story about policy of the body immune system exerted by the intestinal tract, and there is rather great animal information to suggest it.” The trial is ongoing, with outcomes anticipated to be revealed in 2004.

Is Type 1 Diabetes Curable?

TRIGR

The Trial to Reduce Diabetes in the Genetically At-Risk (TRIGR) is based upon an intriguing but controversial concept. Both human and animal research studies from Finland, which has amongst the greatest rates of type 1 diabetes worldwide, recommend that children who are breastfed exclusively from birth and are not exposed to proteins from cow’s milk (in either baby formula or routine milk) might have a lower risk for developing type 1 diabetes.

“In research studies done both in Toronto and Finland in mice, those mice that were fed the cow-milk protein were more likely to come down with diabetes than those fed a hydrolyzed formula [in which the proteins have actually been pre-digested and are not found by the immune system],” states Peggy Franciscus, Registered Nurse, planner for the U.S. arm of the TRIGR trial, based at Children’s Hospital of Pittsburgh.

“Based on that and looking at some of the Finnish studies, those children who were weaned early from breastfeeding — say before 4 months — then given a cow-milk protein formula had a higher occurrence of type 1 diabetes than those who were either solely breastfed past that three-month period, or were placed on a formula with pre-digested protein.’

The theory, Franciscus informs us, is that the entire protein is seen by the child’s still-developing immune system as foreign, triggering it to produce antibodies that attack both the protein and the child’s own shop of insulin producing beta-islet cells of the pancreas. The theory is supported by data from a small Finnish research study that shows children who received cow-milk protein formulas had proof in the blood stream of islet-cell autoantibodies, which are believed to be a possible reason for type 1 diabetes.

“The start of the story is that people saw that in Western Samoa, there was no type 1 diabetes. But when those individuals transfer to societies that use milk products — and in Western Samoa till just recently they did not — they begin to obtain diabetes, and they do get it in Western Samoa now and they do consume milk proteins,” explains Dupre, who is a principal investigator for the Canadian branch of the TRIGR study.

Similar observations have actually been made in the island of Sardinia, where up until just recently goat’s milk however not cow’s milk prevailed in the diet, and in Puerto Rico, where government-sponsored nutrition programs have actually increased using infant formulas based on cow’s milk, Dupre informs us.

The final results from the TRIGR study are not anticipated till about 2007.

Also read: Type 1 Diabetes in Adults

DAISY

The DAISY trial (the Diabetes AutoImmune Study in the Young) was created to address the concern whether certain types of stomach virus (enterovirus) could cause increased susceptibility to diabetes. The study looked at two alternate hypotheses: that enteroviruses are either sent from the mother at birth or gotten in early childhood, resulting in a chronic infection that causes an autoimmune response, or that late infections acquired by children who already have irregular beta-islet cell function can put the final nail in the casket of the insulin-secreting cells.

However like the DPT-1 trial, this research study yielded negative results. “There is no evidence from this study that enterovirus infection is a risk factor for development of beta-cell autoimmunity,” researchers write in the January 2003 issue of the journal Diabetes Research and Clinical Practice.

ENDIT

The European Nicotinamide Diabetes Intervention Trial, or ENDIT, performed in Europe, Canada, and the U.S., is looking at whether high doses of nicotinamide, a form of Vitamin B3 with antioxidant residential or commercial properties, can help to maintain beta-islet cell function in people at risk for type 1 diabetes due to their family history. Trial results, revealed at a European diabetes conference in early 2003, indicated that the supplement used no additional security versus diabetes, Dupre tells us.

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