[Prevention of type 1 diabetes: what have we achieved? What should we say and propose next to families?].
Prevention of type 1 diabetes in high risk individuals presents with both positive and negative aspects. On one hand, the availability of reliable and convenient screening tools (antibodies) allows us to quantify the risk of diabetes in the short term. Large randomised studies have provided indisputable answers regarding the efficiency of selection of at risk patients. Unfortunately, both DPT-1 study (using insulin) and ENDIT trial (with nicotinamide) ruined the hopes raised from solid experimental data. These studies have also demonstrated the huge costs in terms of number of subjects, time for follow-up, and financial burden, requiring an international collaboration. Finally, only a small number of such studies can be conducted simultaneously. Progress and obstacles paving this research area must be explained to diabetic patients and their family. Current mitigated results should not drive us to give up screening campaigns. Rather, these results should prompt diabetes centers and families to participate in the selection of high risk individuals in order to explore new therapeutic options within future prevention trials.
Vialettes
B
B
Service de Nutrition, Maladies métaboliques et Endocrinologie, Hôpital Sainte Marguerite, CHU de Marseille, 270 boulevard Sainte Marguerite, BP 29, 13009 Marseilles, France. bvialett@ap-hm.fr
Valéro
R
R
Mattei
C
C
Nervi
S
S
D001323:Autoantibodies / Q000097:blood; D015415:Biomarkers / Q000032:analysis; D003922:Diabetes Mellitus, Type 1 / Q000175:diagnosis / Q000235:genetics / Q000276:immunology / Q000517:prevention & control*; D005819:Genetic Markers; D006801:Humans; D007328:Insulin; D009536:Niacinamide; D012307:Risk Factors
D001323:Autoantibodies; D015415:Biomarkers; D005819:Genetic Markers; D007328:Insulin; D009536:Niacinamide