The challenge of preventing and treating a disease with great heterogeneity

Authors

  • Miriam Tonietti Dr. Ricardo Gutiérrez Children's Hospital, Autonomous City of Buenos Aires, Argentina

DOI:

https://doi.org/10.47196/diab.v57i3.720

Keywords:

type 1 diabetes mellitus, beta cell, teplizumab

Abstract

Diabetes mellitus 1 (DM1) is an organ-specific autoimmune disease that results from the chronic immune-mediated destruction of insulin-producing β cells and affects more than 14 million people worldwide. It is a progressive process characterized by a preclinical phase of variable asymptomatic evolution, with the appearance of multiple autoantibodies that precede the development of dysglycemia and, subsequently, by a clinical phase with the typical cardinal symptoms that contribute to the diagnosis.

Although insulin was discovered a century ago and the development of new technologies to administer and monitor treatment has reduced the rate of complications and improved the quality of life of people with DM, the disease is still incurable. Patients require multiple daily injections or continuous insulin infusion systems to maintain acceptable blood glucose levels. And, despite these advances in intensive monitoring and treatment, most do not achieve metabolic objectives. The burden of living with DM is considerable for the patient, the family, and society.

Author Biography

Miriam Tonietti, Dr. Ricardo Gutiérrez Children's Hospital, Autonomous City of Buenos Aires, Argentina

Pediatrician, Nutrition specialist

References

I. Herold KC, Bundy BN, Long SA, Bluestone JA, DiMeglio LA, Dufort MJ, Gitelman SE, Gottlieb PA, Krischer JP, Linsley PS, Marks JB, Moore W, Moran A, Rodríguez H, Russell WE, Schatz D, Skyler JS, Tsalikian E, Wherrett DK, Ziegler AG, Greenbaum CJ; Type 1 Diabetes TrialNet Study Group. An anti-CD3 antibody, teplizumab, in relatives at risk for type 1 fiabetes. N Engl J Med 2019 Aug 15; 381(7):603-613. doi: 10.1056/NEJMoa1902226.

II. Herold KC, Gitelman S, Gottlieb P, Knecht L, Raymond R, Ramos E. Teplizumab: a disease-modifying therapy for type 1 diabetes that preserves b-cell function. Diabetes Care 2023;46(10):1-9. doi: 10.2337/dc23-0675.

III. Hollander NHM, Roep BO. From disease and patient heterogeneity to precision medicine in type 1 diabetes. Front Med 2022;9:932086. doi: 10.3389/fmed.2022.932086.

IV. Palmer JP. MD C-peptide in the natural history of type 1 diabetes. Diabetes Metab Res Rev 2009 May;25(4):325-328. doi:10.1002/dmrr.943.

V. Nagy G, Szekely T, Somogyi A , Herold M, Herold Z. New therapeutic approaches for type 1 diabetes: disease-modifying therapies. World J Diabetes 2022;13(10): 835-850. doi: 10.4239/wjd.v13.i10.835.

VI. Herold K, Gitelman S, Gottlieb P, Knecht L, Raymond R, Ramos E. Teplizumab: a disease-modifying therapy for type 1 diabetes that oreserves b-cell function. Diabetes Care 2023;46:1848-1856. doi: 10.2337/dc23-0675.

Published

2023-12-12

How to Cite

Tonietti, M. (2023). The challenge of preventing and treating a disease with great heterogeneity. Journal of the Argentine Society of Diabetes, 57(3). https://doi.org/10.47196/diab.v57i3.720

Similar Articles

You may also start an advanced similarity search for this article.

Most read articles by the same author(s)