title: Type 1 Diabetes Prevention: A Goal Dependent on Accepting a Diagnosis of an Asymptomatic Disease.
abstract: Type 1 diabetes, a disease defined by absolute insulin deficiency, is considered a chronic autoimmune disorder resulting from the destruction of insulin-producing pancreatic β-cells. The incidence of childhood-onset type 1 diabetes has been increasing at a rate of 3%-5% per year globally. Despite the introduction of an impressive array of therapies aimed at improving disease management, no means for a practical "cure" exist. This said, hope remains high that any of a number of emerging technologies (e.g., continuous glucose monitoring, insulin pumps, smart algorithms), alongside advances in stem cell biology, cell encapsulation methodologies, and immunotherapy, will eventually impact the lives of those with recently diagnosed or established type 1 diabetes. However, efforts aimed at reversing insulin dependence do not address the obvious benefits of disease prevention. Hence, key "stretch goals" for type 1 diabetes research include identifying improved and increasingly practical means for diagnosing the disease at earlier stages in its natural history (i.e., early, presymptomatic diagnosis), undertaking such efforts in the population at large to optimally identify those with presymptomatic type 1 diabetes, and introducing safe and effective therapeutic options for prevention.
authors.affiliation: Institute of Diabetes Research, Helmholtz Zentrum München, Neuherberg, Germany.|Forschergruppe Diabetes, Klinikum rechts der Isar, Technische Universität München, München, Germany.
authors.forename: Anette-G
authors.initials: AG
authors.lastname: Ziegler
authors.affiliation: DFG-Center for Regenerative Therapies Dresden, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany.|Paul Langerhans Institute Dresden, German Center for Diabetes Research (DZD), Technische Universität Dresden, Dresden, Germany.|Forschergruppe Diabetes e.V., Neuherberg, Germany.
authors.forename: Ezio
authors.initials: E
authors.lastname: Bonifacio
authors.affiliation: Department of Molecular Physiology and Biophysics, Vanderbilt University, Nashville, TN.|Division of Diabetes, Endocrinology, and Metabolism, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN.|VA Tennessee Valley Healthcare System, Nashville, TN.
authors.forename: Alvin C
authors.initials: AC
authors.lastname: Powers
authors.affiliation: JDRF/Wellcome Trust Diabetes and Inflammation Laboratory, Cambridge Institute for Medical Research, University of Cambridge, Cambridge, U.K.
authors.forename: John A
authors.initials: JA
authors.lastname: Todd
authors.affiliation: Walter and Eliza Hall Institute of Medical Research, Department of Medical Biology, University of Melbourne, Parkville, Victoria, Australia.
authors.forename: Leonard C
authors.initials: LC
authors.lastname: Harrison
authors.affiliation: Departments of Pathology and Pediatrics, UF Diabetes Institute, University of Florida, Gainesville, FL atkinson@ufl.edu.
authors.forename: Mark A
authors.initials: MA
authors.lastname: Atkinson
mesh_terms: D058070:Asymptomatic Diseases; D001786:Blood Glucose / Q000032:analysis; D015190:Blood Glucose Self-Monitoring; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000175:diagnosis* / Q000188:drug therapy / Q000517:prevention & control*; D006801:Humans; D007328:Insulin / Q000627:therapeutic use
chemical_list: D001786:Blood Glucose; D007328:Insulin