title: [Recent advances in the treatment of type 1 diabetes mellitus].
abstract: INTERVENTIONAL APPROACHES TO BETA CELL PRESERVATION: In a pilot study, initial attempts at primary prevention by preserving islet beta cells have been successful with highly hydrolyzed milk formula in children who are at high genetic risk of diabetes. Attempts at secondary prevention by intranasal application in children with a high-risk HLA genotype and positive islet autoantibodies have been disappointing. But in tertiary prevention anti-inflammatory, antigen-directed and T-cell targeted treatment has been partially successful in slowing down the destruction of beta cells. BIOLOGICAL BETA CELL SUBSTITUTION: Transplantation of a vascularised pancreas or islet cells results in disease regression and the prevention of secondary/tertiary complications of diabetes. A principal aim is the avoidance of frequent, severe hypoglycaemic episodes resulting from markedly reduced awareness of hypoglycaemia or its counter-regulation.
authors.affiliation: Institut für Klinische Diabetologie am Deutschen Diabetes-Zentrum Universität Düsseldorf, 6540225 Düsseldorf.
authors.forename: N C
authors.initials: NC
authors.lastname: Schloot
authors.forename: M
authors.initials: M
authors.lastname: Roden
authors.forename: S R
authors.initials: SR
authors.lastname: Bornstein
authors.forename: M D
authors.initials: MD
authors.lastname: Brendel
mesh_terms: D000281:Administration, Intranasal; D000284:Administration, Oral; D000293:Adolescent; D000328:Adult; D001323:Autoantibodies / Q000097:blood; D002470:Cell Survival / Q000502:physiology; D002648:Child; D002675:Child, Preschool; D048909:Diabetes Complications / Q000276:immunology / Q000517:prevention & control; D003922:Diabetes Mellitus, Type 1 / Q000235:genetics / Q000276:immunology / Q000503:physiopathology / Q000628:therapy*; D005838:Genotype; D006801:Humans; D006868:Hydrolysis; D007004:Hypoglycemic Agents / Q000008:administration & dosage; D007223:Infant; D041943:Infant Formula / Q000008:administration & dosage; D007328:Insulin / Q000008:administration & dosage / Q000097:blood; D050417:Insulin-Secreting Cells / Q000276:immunology / Q000502:physiology / Q000637:transplantation; D053590:Interleukin 1 Receptor Antagonist Protein / Q000627:therapeutic use; D016381:Islets of Langerhans Transplantation; D008894:Milk Proteins; D015337:Multicenter Studies as Topic; D016035:Pancreas Transplantation; D010865:Pilot Projects; D017472:Receptors, Interleukin-1 / Q000037:antagonists & inhibitors; D012307:Risk Factors; D013601:T-Lymphocytes / Q000187:drug effects / Q000276:immunology; D055815:Young Adult
chemical_list: D001323:Autoantibodies; D007004:Hypoglycemic Agents; D007328:Insulin; D053590:Interleukin 1 Receptor Antagonist Protein; D008894:Milk Proteins; D017472:Receptors, Interleukin-1