nr. 477 - 2011 - Institut for Natur, Systemer og Modeller (NSM)

3 Prospects for Therapy – A Mini Review
As more information about the etiology of diabetes has become available, several possible
means of preventing/curing it have surfaced. In this chapter we give a brief account
of some of these.
3.1 Treatment Strategies
Depending on the progression of the disease different therapeutical approaches are relevant
(Greenbaum and Harrison (2008)), though some of them are not confined to one
stage. Figure 3.1 gives a qualitative indication of how the amount of β-cells left is
related to treatment strategy, how prediction becomes more and more accurate with
time while prevention of T1D becomes less and less possible.
Firstly and most ideally every infant should be genetically screened to test for genes
Figure 3.1 shows how different treatment strategies apply as β-cell mass is reduced over time.
On the y-axis we have β-cell mass and along the x-axis we have time. As time passes the
ability to prevent T1D becomes smaller and smaller. Figure was borrowed, with permission,
from Staeva-Vieira et al. (2008)
that are linked with T1D. This would permit for precautionary measures such as diet
changes or antigen-based therapy. The only problem with this is that these genes need
still be identified.
Secondly, when autoimmunity is observed, antigen therapy is still an option, but also
direct administration of regulatory cells (e.g. macrophages) has been suggested. At
this stage the aim of the treatment is to prevent β-cell destruction.
Unless the autoimmunity is treated it will inevitably lead to β-cell destruction, the
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