[Prevention of juvenile diabetes (type 1): reality or fiction?].
A better knowledge of the pathogenesis of type 1 diabetes (IDDM) may open the road to the prevention of the diseases. Primary prevention is meant to identify susceptible subjects, either soon after birth or before the immunological aggression of beta cells. The practical approach in this respect is very difficult because multiple obstacles must be overcome. Secondary prevention involves subjects who already show immunological or metabolic alterations, as the presence of ICA, antiinsulin antibodies, GAD antibodies and a defect of the first phase of insulin secretion. Most authors attach great interest to trials with insulin and nicotinamide. Insulin seems to reduce antigen expression when beta cells are damaged. Nicotinamide exerts a protection toward diabetes in animals, and, as scavanger of free radicals, facilitates beta cell regeneration. Research is going on, all over the world, and special multicenter trials are in progress both in the USA and Europe.
Andreani
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Centro per gli stati disendocrini e dismetabolici, Universita degli studi di Roma La Sapienza.
D000293:Adolescent; D015551:Autoimmunity; D002648:Child; D002675:Child, Preschool; D016572:Cyclosporine / Q000627:therapeutic use; D003922:Diabetes Mellitus, Type 1 / Q000276:immunology / Q000517:prevention & control*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007328:Insulin / Q000378:metabolism; D007330:Insulin Antibodies / Q000276:immunology; D000078790:Insulin Secretion; D009536:Niacinamide / Q000627:therapeutic use; D011322:Primary Prevention
D007328:Insulin; D007330:Insulin Antibodies; D009536:Niacinamide; D016572:Cyclosporine
Prévention du diabète juvénile (type 1): réalité ou fiction?