Type 1 Diabetes Through the Life Span: A Position Statement of the American Diabetes Association

Jane L. Chiang; M. Sue Kirkman; Lori M.B. Laffel; Anne L. Peters


Diabetes Care. 2014;37(7):2034-2054. 

In This Article


Therapy trials to prevent type 1 diabetes development (prevention), to preserve remaining β-cells (preservation), and to replace β-cells (transplantation) are ongoing. Although means are available to screen and predict family members at risk for developing type 1 diabetes, efforts to delay or prevent disease onset have been largely disappointing. A variety of different immunomodulatory and immune-suppressive agents have been evaluated in patients with recent-onset type 1 diabetes, and the effects have been modest at best: for the subset of drugs that appear to have an effect, not all patients respond; for those who do, the effects are generally transient. Many of the agents tested to date are FDA approved for other indications, but given the observations to date and potential toxicities, the recommendation is that patients should only receive these drugs after being enrolled in clinical research protocols with appropriate follow-up. Long-term safety and efficacy data are scarce, especially in children. Investigators continue to evaluate promising new agents and combinations of drugs or cell-based therapies in an effort to safely and effectively modulate the autoimmune response.[70]