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Researchers target type 1 diabetes prevention

Treatment has improved, but the means to stop the disease remains elusive.

By Victoria Stagg Elliott, amednews staff. Sept. 27, 2004.

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Type 1 diabetes, often viewed as inevitable for those predisposed to it, could one day be as preventable as its well-known relative, type 2.

Such a shift in understanding would be revolutionary. It also would create a need for primary care physicians to take on screening and prevention for type 1 with the same vigor as they currently do for type 2.

For now, though, prevention of type 1 is a proposition of someday, spoken of in terms of "if," not "when." Even so, many experts believe that they now possess important clues that will help them solve the mystery of how to stop it before it starts.

To that end, the National Institute of Diabetes and Digestive and Kidney Diseases in June launched TrialNet, an international network of 18 centers that will study interventions that may prevent development of the disease and improve the prospects for those newly diagnosed with it.

"This will absolutely be in the purview of primary care physicians once we have something that we really think delays or prevents diabetes," said Ellen Leschek, MD, TrialNet's program director. "Even if you're talking about delaying by just two or three years, that's substantial, because every moment that you have diabetes, those are moments that are contributing towards having the long-term effects."

The network is building on the work of the Diabetes Prevention Trial-Type 1, also funded by NIDDK and launched in 1995, which examined the use of low doses of injectable insulin or oral insulin to prevent the development of the disease in those at high risk.