Prävention des typ-1-diabetes

In 2002, major results of DPT-1 and ENDIT, the two largest intervention trials based on relatives at risk of type 1 diabetes, were reported. Subcutaneous insulin and nicotinamide had no protective effect on the development of diabetes. Research will now focus on tertiary intervention in newly diagnosed type 1 diabetes (end-point: preservation of β-cell reserve) as well as on primary diabetes prevention (endpoint: prevention of islet autoimmunity). New multicenter studies on manifestation of the disease have begun only recently (interventions using monoclonal CD3-antibodies [ChAgly-CD3, CD-OKT3], altered peptide ligand NBI-6024, peptide p277, vitamin D₃). Preliminary results of studies using CD-OKT3 or DiaPep277 are encouraging. Important projects in primary prevention are the ongoing TRIGR trial, which evaluates the effects of avoiding cow milk proteins for the first 6 months of life in children genetically at risk of type 1 diabetes, and the German BABYDIET-study, which studies the effects of a gluten-free nutrition during the first 12 months of life in children and siblings of patients with type 1 diabetes.