Pande Arun K, Dutta Deep, Singla Rajiv
Consultant Endocrinologist, Lucknow Endocrine Diabetes and Thyroid Clinic, Lucknow, Uttar Pradesh, India.
Consultant Endocrinologist, CEDAR Superspeciality Healthcare, Dwarka, New Delhi, India.
Indian J Endocrinol Metab. 2023 Jul-Aug;27(4):277-285. doi: 10.4103/ijem.ijem_78_23. Epub 2023 Aug 28.
People living with type 1 Diabetes (T1D) and their families have poor perception of health related quality of life. Therapies for T1D are becoming better with time, but they still involve a lot of effort. Prevention of T1D, if successful, has potential to change lives of millions of families across the globe. Type 1 diabetes is an autoimmune disease with underlying genetic predisposition for autoimmunity against beta cell antigens upon exposure to an environmental trigger. Identifying underlying primary antigen responsible for initiating autoimmune cascade, avoiding environmental trigger and modifying immunity has all been used as strategies for preventing or delaying onset of type 1 diabetes. Primary prevention for type 1 diabetes is hindered by difficulty in identifying at-risk population and also due to lack of effective preventive strategy. Secondary prevention, in children with presence of autoimmunity, has recently received a boost with approval of Teplizumab, an immunity modifying drug by its Anti-CD3 action. Application of preventive strategies would also change based on country specific incidence, prevalence and availability of health resources. In current review, an update on preventive strategies for type 1 diabetes is being discussed as well as their applicability in Indian context.
1型糖尿病（T1D）患者及其家人对健康相关生活质量的认知较差。随着时间的推移，T1D的治疗方法在不断改进，但仍需要付出很多努力。如果1型糖尿病的预防取得成功，有可能改变全球数百万家庭的生活。1型糖尿病是一种自身免疫性疾病，在接触环境触发因素后，具有针对β细胞抗原的自身免疫潜在遗传易感性。识别引发自身免疫级联反应的潜在主要抗原、避免环境触发因素和调节免疫都已被用作预防或延迟1型糖尿病发病的策略。1型糖尿病的一级预防因难以识别高危人群以及缺乏有效的预防策略而受到阻碍。在患有自身免疫性疾病的儿童中，二级预防最近因抗CD3作用的免疫调节药物替普珠单抗的获批而得到推动。预防策略的应用也将根据国家特定的发病率、患病率和卫生资源的可及性而有所变化。在当前的综述中，将讨论1型糖尿病预防策略的最新情况及其在印度背景下的适用性。
