MOŽE LI SE TIP 1 DIJABETESA PREVENIRATI ?
DOI:
https://doi.org/10.46793/PP190309003SKljučne reči:
Tip 1 dijabetesa, predikcija, prevencija, autoantitela, remisija, metforminApstrakt
Učestalost Tipa 1 dijabetesa melitusa (T1DM) dostiže pandemijske razmere, a povećanje incidencije je najveće u kategoriji najmlađe dece. Iako se bolest uspešno leči egzogenom primenom insulina, ne može se izlečiti. Oboljenje je rezultat sadejstva genetskih i faktora sredine, kao i endogenih faktora. Jasno je da je pritisak faktora sredine na genetski sklone individue pojačan i da tu treba tražiti mogućnosti prevencije. Primarna prevencija otkrivanjem genetski sklonih individua još na rođenju i primenom vakcina protiv dijabetogenih virusa, eradikacija enterovirusa u trudnica, ili eliminacijom pojedinih nutrijenata, optimalnim unosom vitamina D, primenom oralnog insulina, do sada nije smanjila učestalost oboljevanja.Novi biomarkeri predikcije T1DM omogućiće razvoj uspešnijih strategija prevencije. Skrining na pojavu jednog ili vise autoantitela na ćelije ostrvaca kod dece iz rizičnih porodica u trećoj godini, otkriva onu decu koja su kandidati za intervencijske studije. Podesan period za sekundarnu prevenciju je i faza remisije T1DM kada je još uvek očuvana rezidualna funkcija β ćelija, te se može primeniti produženje ovog povoljnog perioda primenom insulinskog senzitajzera, metformina.
Reference
Fonolleda M. Murillo M, Vazquez F, Bel J, Vives-Pi M. Remission phase in pediatric Type 1 diabetes: new understanding and emerging biomarkers. Horm Res Paediatr 2017; 88: 307-315.
Rewers M. Pathogenesis of type 1 diabetes: environmental factors. International Diabetes Monitor. 2010;22:112-20.
Meier JJ. Beta cell mass in diabetes: a realistic therapeutic target ? Diabetologia. 2008;51;703-
Tsai EB, Sherry NA, Palmer JP, Herold KC for the DPT-1 Study Group. The rise and fall of insulin secretion in type 1 diabetes mellitus. Diabetologia. 2006;49:261-70.
Dahlquist G. Can we slow the rising incidence of childhood-onset autoimmune diabetes? The overload hypothesis. Diabetologia 2006;49:20-4.
Wilkin TJ. The accelerator hypothesis: weight gain as a missing link between type I and type II diabetes. Diabetologia. 2001; 44: 914-22.
Wilkin TJ. Changing perspectives in diabetes: their impact on its classification. Diabetologia. 2007; 50:1587-92.
Imagawa A, Hanafusa T, Miyagawa J, Matsuzava Y. A novel subtype of type 1 diabetes mellitus characterized by a rapid onset and an absence of diabetes-related antibodies. Osaka IDDM Study Group. N Engl J Med. 2000; 342:301-7.
Wang I, Wang F-S, Gershwin ME. Human autoimmune diseases; a comprehensive update. J intern Med 2015; 278: 369-395
Michels A, Zhang L, Khadra A, Kushner JA, Redondo MJ, Pietropaolo M. Prediction and prevention of Type 1 diabetes: update on success of prediction and struggles at prevention. Pediatric Diabetes 2015; 16(7): 465-484
Paschou SA, papadopoulou-Marketou N, Chrousos GP, Kanaka-Gantenbein K. On Type 1 diabetes mellitus pathogenesis (Review). Endocrine Connections 2018; 7 (1): 38-46.
Perheentupa J.APS-I/APECED: the clinical disease and therapy. Endocrinol Metab Clin North Am 2002; 31: 295-320.
Saranac L, Samardžic M. Diabetes mellitus in childhood; facts and controversies.(Review) Paediatrics Today 2011; 7(1): 10-17.
Gillespie KM. Type 1 diabetes: pathogenesis and prevention. CMAJ 2006; 175(2): 165-70.
Jacobsen LM, Haller MJ, Schatz DA. Understanding pre-type 1 diabetes: the key to prevention. Front in Endocrinol 2018; 9 art 70: 1-8.
Michels AW., Gottlieb PA. Learning from past failures of oral insulin trials. Diabetes 2018; 67: 1211-1215.
Imam S, Prathibha R, Dar P, Alotah K Al-Khudhair A, Abdul-Moiz S et al. EIF5A inhibition influences T cell dynamics in the pancreatic microenvironment of the humanized mouse model of Type 1 diabetes. Scientific Reports 2019; 9(1): DOI: 10.1038/s41598-018-38341-5
Ostrov DA, Alkanani A, McDaniel KA. Case S, Baschal EE, Pyle L, et al. Methyldopa blocks MHC class II binding to disease-specific antigens in autoimmune diabetes. J Clin Invest 2018; 128: 1888-1902.
Raab J, Haupt F, Scholtz M, Matzke K, Warncke K, Lange K et al. Capillary blood islet autoantibody screening for identifying pre-type 1 diabetes in the general population: design and initial results of the Fr1da study. BMJ Open 2016;6: e011144, DOI: 10.1136/bmjopen-2016-011144
Wilkin TJ. The accelerator hypothesis: weight gain as a missing link between type I and type II diabetes. Diabetologia. 2001; 44: 914-22.
Wilkin TJ. Changing perspectives in diabetes: their impact on its classification. Diabetologia. 2007; 50:1587-92.
Wilkin TJ. The great weight gain experiment, accelerators and their implications for autoantibodies in diabetes. Arh Dis Child. 2006;91:456-8.
Wilkin TJ. The accelerator hypothesis-an evolving concept. Facta Univ Ser Med Biol 2015; 17(2): 49-53
Saranac L, Zivanovic S, Kostic G, Bjelakovic B, Novak M. Combined treatment in childhood diabetes could influence remission period. Abstr European Congress of Endocrinology 2009, Istanbul. Endocrine Abstracts. 2009;20: 382.
Saranac L, Bjelakovic B, Zivanovic S, Novak M. Intervention with metformin in childhood diabetes may slow decline of C peptide - the accelerator hypothesis. Abstr 46th Ann Meet EASD, Stocholm, 2010. Diabetologia. 2010;53 (Suppl 1): S 372.
Livingstone R, Boyle JG, Petrie JR. on behalf of The REMOVAL study team. A new perspective on metformin therapy in type 1 diabetes. Diabetologia 2017; 60: 1594-1600.
Denroche HC, Nackiewicz D, Verchere CB. When beta cells talk back. Diabetologia 2018; 61: 39-42.
Sims E, Evans-Molina, Tersey SA, Eizirik DL, Mirmira RG. Biomarkers of beta cell stress and death in type 1 diabetes. Diabetologia 2018; 61; 2259-2265.
Mathieu Chantal, Lahesmaa R, Bonifacio E, Achenbach P, Tree T. Immunological biomarkers for the development and progression of type 1 diabetes. Diabetologia 2018; 61: 2252-2258.
