Are We Ready With Prevention for Type 1 Diabetes?

TL;DR

This review discusses current and emerging therapies for preventing or delaying type 1 diabetes in children, highlighting progress and challenges in disease-modifying treatments.

Contribution

The paper provides a comprehensive overview of recent advancements in T1D prevention strategies for youth.

Findings

Teplizumab is the only FDA-approved drug to delay the onset of Stage 3 T1D.

Various therapies targeting immune cells and cytokines show potential but have limited long-term benefits.

Future research is needed to improve patient selection and treatment durability.

Abstract

Definitive prevention for type 1 diabetes (T1D) is not yet available, but we are now entering a new era where disease‐modifying therapies are becoming available in T1D to halt disease progression. In this review, we present up‐to‐date knowledge related to the prevention of T1D in youth, involving disease‐modifying therapies at different T1D stages. A narrative literature review utilising the PubMed/MEDLINE database was performed using the keywords ‘screening’, ‘prevention’, ‘Disease‐modifying therapy’, and ‘Diabetes Mellitus, Type 1’ [Mesh] in youth aged 0–18 years. Only teplizumab has been approved by the FDA as the first drug shown to delay the onset of Stage 3 T1D. Other monoclonal antibodies targeting specific immune cells, agents targeting specific cytokines, antigen‐specific therapies, and immunomodulant and/or immunosuppressive agents have been studied alone or in combination to control or delay the progression of beta‐cell destruction. In individuals with Stage 3 T1D, several intervention trials have led to a temporary improvement in beta‐cell function, but this benefit has consistently been short‐lived. Ongoing and future research will be essential to refine patient selection, identify additional therapeutic targets, and optimise the timing and durability of immunotherapy responses.

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