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Type 1 diabetes (T1D) is an autoimmune disease in which the insulin-producing β cells of the pancreas are destroyed by T lymphocytes. Recent studies have demonstrated that monitoring for pancreatic islet autoantibodies, combined with genetic risk assessment, can identify most children who will develop T1D when they still have sufficient β cell function to control glucose concentrations without the need for insulin. In addition, there has been recent success in secondary prevention using immunotherapy to delay the progression of preclinical disease, and primary prevention approaches to inhibiting the initiating autoimmune process have entered large-scale clinical trials. By changing the focus of T1D management from late diagnosis and insulin replacement to early diagnosis and β cell preservation, we can anticipate a future without the need for daily insulin injections for children with T1D.

Original publication




Journal article


Science (New York, N.Y.)

Publication Date





506 - 510


Wellcome Centre for Human Genetics, Nuffield Department of Medicine, National Institute for Health Research (NIHR) Biomedical Research Centre, University of Oxford, Oxford, UK.


Islets of Langerhans, Humans, Diabetes Mellitus, Type 1, Disease Progression, Genetic Predisposition to Disease, Insulin, Autoantibodies, Early Diagnosis, Primary Prevention, Child, Insulin-Secreting Cells, Secondary Prevention, Genetic Testing, Biomarkers