Nevertheless, genetic factors do not provide a sufficient explanation regarding the development of the disease. These results have offered the possibility of identifying people at risk and to follow them during the years, in order to try to prevent or revert the progression of T1D. Several studies have been focusing on the identification of individuals at risk for T1D, early in the natural history of the disease, using prediction models in which the genetic factors are considered to be important for their time-independence in all subjects. Type 1 diabetes (T1D) is a chronic autoimmune disease characterized by pancreatic beta cell destruction in which genetic susceptibility combined with environmental factors, mostly in early life, plays a crucial role. This review focuses on the major current knowledge on prediction and prevention of T1D in children. In addition, the availability of novel humoral and metabolic biomarkers that are able to characterize subjects at high risk of progression, have stimulated several studies on secondary and tertiary prevention, aimed to preserve residual beta cell destruction and/or to prolong the remission phase after the onset of T1D. Strategies of primary prevention aim to prevent the onset of autoimmunity against beta cells in asymptomatic individuals at high risk for T1D. In view of the long natural history and complex pathogenesis of the disease, many strategies may be proposed for primary, secondary, and tertiary prevention.
In particular, this final stage follows two preceding asymptomatic stages, which have been precisely identified. Once a child becomes symptomatic, beta cell mass has already reached a critical threshold (usually a residual of 20–30% of normal amounts), thus representing only the very late phase of the disease. Recent studies have been focused on several factors, including family history and genetic predisposition (HLA and non-HLA genes) as well as environmental and metabolic biomarkers, with the aim of predicting the development and progression of T1D.
Although several studies in the last decades have added relevant insights, the complex pathogenesis of the disease is not yet completely understood. The disease is characterized by the destruction of beta cells, leading to hyperglycemia, and to a lifelong insulin-dependent state. Type 1 Diabetes (T1D) is one of the most common chronic autoimmune diseases in children.
0 kommentar(er)
