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Factors impeding the discovery of an intervention‐based treatment for type 1 diabetes
Summary Type 1 diabetes (T1D) is one of the most common and severe chronic diseases affecting both children and adults. The aetiology of the disease remains unknown, and thus far no ‘true’ cure for those affected is available. Indeed, exogenous insulin replacement therapy to manage glucose metabolis...
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| Published in: | Clinical and experimental immunology 2016-01, Vol.183 (1), p.1-7 |
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| container_title | Clinical and experimental immunology |
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| creator | von Herrath, M. G. Korsgren, O. Atkinson, M. A. |
| description | Summary
Type 1 diabetes (T1D) is one of the most common and severe chronic diseases affecting both children and adults. The aetiology of the disease remains unknown, and thus far no ‘true’ cure for those affected is available. Indeed, exogenous insulin replacement therapy to manage glucose metabolism to the best degree possible remains the current standard of care. However, despite a recent array of truly impressive improvements designed to enhance disease management (e.g. insulin analogues, continuous glucose monitoring, insulin pumps), it is still difficult for the vast majority of patients to reach recommended target HbA1C levels ( |
| doi_str_mv | 10.1111/cei.12656 |
| format | article |
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Type 1 diabetes (T1D) is one of the most common and severe chronic diseases affecting both children and adults. The aetiology of the disease remains unknown, and thus far no ‘true’ cure for those affected is available. Indeed, exogenous insulin replacement therapy to manage glucose metabolism to the best degree possible remains the current standard of care. However, despite a recent array of truly impressive improvements designed to enhance disease management (e.g. insulin analogues, continuous glucose monitoring, insulin pumps), it is still difficult for the vast majority of patients to reach recommended target HbA1C levels (< 7·0%). As a result of suboptimal disease management, far too many patients with T1D have an increased risk for disease‐associated complications such as nephropathy, neuropathy and retinopathy, as well as hypoglycaemia. New treatment modalities are therefore needed urgently to bring a ‘true’ cure (disease prevention/disease reversal) to patients with T1D. Here we consider issues that collectively pose a major stumbling block in T1D research with respect to identifying a means to prevent and/or cure the disease. We begin this Perspective by discussing new insights emanating from studies of the pancreas in human T1D; findings which may, at least in part, explain why previous interventions seeking disease prevention/reversal have yielded insufficient benefit. We then turn to suggestions that could optimise the outcome of future clinical trials. Finally, we direct attention to recommendations for the global T1D research community; messages we deem to have the potential to improve our chances of finding the elusive T1D ‘cure’.</description><identifier>ISSN: 0009-9104</identifier><identifier>ISSN: 1365-2249</identifier><identifier>EISSN: 1365-2249</identifier><identifier>DOI: 10.1111/cei.12656</identifier><identifier>PMID: 25989477</identifier><language>eng</language><publisher>England: Oxford University Press</publisher><subject>Adult ; Animals ; autoimmune disease ; beta cells ; Blood Glucose - metabolism ; Child ; Diabetes Mellitus, Type 1 - therapy ; Humans ; Hypoglycemic Agents - therapeutic use ; immune therapy ; insulin ; Insulin - therapeutic use ; Pancreas - metabolism ; Pancreas - pathology ; Translational Research, Biomedical ; type 1 diabetes ; Type 1 Diabetes Mini‐series: Pathogenesis and Therapy</subject><ispartof>Clinical and experimental immunology, 2016-01, Vol.183 (1), p.1-7</ispartof><rights>2015 British Society for Immunology</rights><rights>2015 British Society for Immunology.</rights><rights>2016 British Society for Immunology</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c5136-fbeb17c4758bd5b05502577c736a9e8f97c6339908038cd59a8650d1fe29ff033</citedby><cites>FETCH-LOGICAL-c5136-fbeb17c4758bd5b05502577c736a9e8f97c6339908038cd59a8650d1fe29ff033</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4687509/pdf/$$EPDF$$P50$$Gpubmedcentral$$H</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4687509/$$EHTML$$P50$$Gpubmedcentral$$H</linktohtml><link.rule.ids>230,314,727,780,784,885,27923,27924,53790,53792</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/25989477$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink><backlink>$$Uhttps://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-280093$$DView record from Swedish Publication Index$$Hfree_for_read</backlink></links><search><creatorcontrib>von Herrath, M. G.</creatorcontrib><creatorcontrib>Korsgren, O.</creatorcontrib><creatorcontrib>Atkinson, M. A.</creatorcontrib><title>Factors impeding the discovery of an intervention‐based treatment for type 1 diabetes</title><title>Clinical and experimental immunology</title><addtitle>Clin Exp Immunol</addtitle><description>Summary
Type 1 diabetes (T1D) is one of the most common and severe chronic diseases affecting both children and adults. The aetiology of the disease remains unknown, and thus far no ‘true’ cure for those affected is available. Indeed, exogenous insulin replacement therapy to manage glucose metabolism to the best degree possible remains the current standard of care. However, despite a recent array of truly impressive improvements designed to enhance disease management (e.g. insulin analogues, continuous glucose monitoring, insulin pumps), it is still difficult for the vast majority of patients to reach recommended target HbA1C levels (< 7·0%). As a result of suboptimal disease management, far too many patients with T1D have an increased risk for disease‐associated complications such as nephropathy, neuropathy and retinopathy, as well as hypoglycaemia. New treatment modalities are therefore needed urgently to bring a ‘true’ cure (disease prevention/disease reversal) to patients with T1D. Here we consider issues that collectively pose a major stumbling block in T1D research with respect to identifying a means to prevent and/or cure the disease. We begin this Perspective by discussing new insights emanating from studies of the pancreas in human T1D; findings which may, at least in part, explain why previous interventions seeking disease prevention/reversal have yielded insufficient benefit. We then turn to suggestions that could optimise the outcome of future clinical trials. Finally, we direct attention to recommendations for the global T1D research community; messages we deem to have the potential to improve our chances of finding the elusive T1D ‘cure’.</description><subject>Adult</subject><subject>Animals</subject><subject>autoimmune disease</subject><subject>beta cells</subject><subject>Blood Glucose - metabolism</subject><subject>Child</subject><subject>Diabetes Mellitus, Type 1 - therapy</subject><subject>Humans</subject><subject>Hypoglycemic Agents - therapeutic use</subject><subject>immune therapy</subject><subject>insulin</subject><subject>Insulin - therapeutic use</subject><subject>Pancreas - metabolism</subject><subject>Pancreas - pathology</subject><subject>Translational Research, Biomedical</subject><subject>type 1 diabetes</subject><subject>Type 1 Diabetes Mini‐series: Pathogenesis and Therapy</subject><issn>0009-9104</issn><issn>1365-2249</issn><issn>1365-2249</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2016</creationdate><recordtype>article</recordtype><recordid>eNqNks1u1DAUhS1ERYeBBS-ALLGhEmltJ_7bVKqmLVSqxIafpeU4N1NXSTzYyVSz4xF4Rp4El7QVRULCG8v2d4-Oz70IvaLkkOZ15MAfUia4eIIWtBS8YKzST9GCEKILTUm1j56ndJ2PQgj2DO0zrpWupFygr-fWjSEm7PsNNH5Y4_EKcOOTC1uIOxxabAfshxHiFobRh-Hn9x-1TdDgMYId-3yJ2xDxuNsAprnS1jBCeoH2WtsleHm3L9Hn87NPqw_F5cf3F6uTy8Lx7LRoa6ipdJXkqm54TTgnjEvpZCmsBtVq6URZak0UKZVruLZKcNLQFphuW1KWS_Ru1k03sJlqs4m-t3FngvXm1H85MSGuzTQZpnIWt_jxjGe2h8Zl99F2j6oevwz-yqzD1lRCSZ4VlujtnUAM3yZIo-lzVtB1doAwJUOlFIJrLsR_oIIoxXMjMvrmL_Q6THHIwWWKS8qYYDJTBzPlYkgpQvvgmxJzOwgmD4L5PQiZff3nRx_I-85n4GgGbnwHu38rmdXZxSz5C3PEvZ0</recordid><startdate>201601</startdate><enddate>201601</enddate><creator>von Herrath, M. G.</creator><creator>Korsgren, O.</creator><creator>Atkinson, M. A.</creator><general>Oxford University Press</general><general>John Wiley and Sons Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7T5</scope><scope>7U9</scope><scope>H94</scope><scope>M7N</scope><scope>7X8</scope><scope>5PM</scope><scope>ADTPV</scope><scope>AOWAS</scope><scope>DF2</scope></search><sort><creationdate>201601</creationdate><title>Factors impeding the discovery of an intervention‐based treatment for type 1 diabetes</title><author>von Herrath, M. G. ; Korsgren, O. ; Atkinson, M. A.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c5136-fbeb17c4758bd5b05502577c736a9e8f97c6339908038cd59a8650d1fe29ff033</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2016</creationdate><topic>Adult</topic><topic>Animals</topic><topic>autoimmune disease</topic><topic>beta cells</topic><topic>Blood Glucose - metabolism</topic><topic>Child</topic><topic>Diabetes Mellitus, Type 1 - therapy</topic><topic>Humans</topic><topic>Hypoglycemic Agents - therapeutic use</topic><topic>immune therapy</topic><topic>insulin</topic><topic>Insulin - therapeutic use</topic><topic>Pancreas - metabolism</topic><topic>Pancreas - pathology</topic><topic>Translational Research, Biomedical</topic><topic>type 1 diabetes</topic><topic>Type 1 Diabetes Mini‐series: Pathogenesis and Therapy</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>von Herrath, M. G.</creatorcontrib><creatorcontrib>Korsgren, O.</creatorcontrib><creatorcontrib>Atkinson, M. A.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Immunology Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>SwePub</collection><collection>SwePub Articles</collection><collection>SWEPUB Uppsala universitet</collection><jtitle>Clinical and experimental immunology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>von Herrath, M. G.</au><au>Korsgren, O.</au><au>Atkinson, M. A.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Factors impeding the discovery of an intervention‐based treatment for type 1 diabetes</atitle><jtitle>Clinical and experimental immunology</jtitle><addtitle>Clin Exp Immunol</addtitle><date>2016-01</date><risdate>2016</risdate><volume>183</volume><issue>1</issue><spage>1</spage><epage>7</epage><pages>1-7</pages><issn>0009-9104</issn><issn>1365-2249</issn><eissn>1365-2249</eissn><abstract>Summary
Type 1 diabetes (T1D) is one of the most common and severe chronic diseases affecting both children and adults. The aetiology of the disease remains unknown, and thus far no ‘true’ cure for those affected is available. Indeed, exogenous insulin replacement therapy to manage glucose metabolism to the best degree possible remains the current standard of care. However, despite a recent array of truly impressive improvements designed to enhance disease management (e.g. insulin analogues, continuous glucose monitoring, insulin pumps), it is still difficult for the vast majority of patients to reach recommended target HbA1C levels (< 7·0%). As a result of suboptimal disease management, far too many patients with T1D have an increased risk for disease‐associated complications such as nephropathy, neuropathy and retinopathy, as well as hypoglycaemia. New treatment modalities are therefore needed urgently to bring a ‘true’ cure (disease prevention/disease reversal) to patients with T1D. Here we consider issues that collectively pose a major stumbling block in T1D research with respect to identifying a means to prevent and/or cure the disease. We begin this Perspective by discussing new insights emanating from studies of the pancreas in human T1D; findings which may, at least in part, explain why previous interventions seeking disease prevention/reversal have yielded insufficient benefit. We then turn to suggestions that could optimise the outcome of future clinical trials. Finally, we direct attention to recommendations for the global T1D research community; messages we deem to have the potential to improve our chances of finding the elusive T1D ‘cure’.</abstract><cop>England</cop><pub>Oxford University Press</pub><pmid>25989477</pmid><doi>10.1111/cei.12656</doi><tpages>7</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | Clinical and experimental immunology, 2016-01, Vol.183 (1), p.1-7 |
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| source | Oxford Journals Online; PubMed Central |
| subjects | Adult Animals autoimmune disease beta cells Blood Glucose - metabolism Child Diabetes Mellitus, Type 1 - therapy Humans Hypoglycemic Agents - therapeutic use immune therapy insulin Insulin - therapeutic use Pancreas - metabolism Pancreas - pathology Translational Research, Biomedical type 1 diabetes Type 1 Diabetes Mini‐series: Pathogenesis and Therapy |
| title | Factors impeding the discovery of an intervention‐based treatment for type 1 diabetes |
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