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Shortening the paths to type 1 diabetes mellitus prevention

The development and application of effective immunotherapies for type 1 diabetes mellitus has lagged behind our ability to identify and stage individuals in pre-clinical stages of disease. This Year in Review addresses advances in immunotherapy aimed towards prevention and our readiness to roll out screening in the broader population.

Key advances

  • Low-dose IL-2 is seemingly safe and expands the number of CD4+CD25+ regulatory T (Treg) cells in children with type 1 diabetes mellitus (T1DM)4.

  • The first study of a monoclonal anti-IL-7R antibody in patients with T1DM finds a dose that reduces effector and memory T cell numbers while preserving Treg cell populations in patients with T1DM6.

  • Post-hoc metabolic outcome analysis of two earlier trials indicates that oral insulin slows the decline of islet metabolic function in high-risk pre-symptomatic individuals9.

  • A successful public health application of islet autoantibody screening was carried out in 2015–2019 in German pre-school children to identify, stage and provide care for children with pre-symptomatic T1DM10.

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Correspondence to Anette-G. Ziegler.

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Ziegler, AG., Bonifacio, E. Shortening the paths to type 1 diabetes mellitus prevention. Nat Rev Endocrinol 17, 73–74 (2021).

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