Thread by @DUK_research

Fair to say #Type2diabetes has grabbed the limelight this morning, but now for some exciting updates on #Type1diabetes prevention
#dukpc

Polly Bingley is up first to talk TrialNet - an international network of scientists dedicated to the prevention of #Type1diabetes.

In people with rheumatoid arthritis you don’t wait until someone needs a joint replacement before you intervene. Similarly, Polly tells us we need to be moving forward the point at which we act to target the immune response that causes #Type1diabetes #dukpc

And thanks to TrialNet we now know a lot more about what’s happens in the immune system before someone is diagnosed with #Type1diabetes #dukpc

TrialNet are running research studies at different points on this path to #Type1diabetes. The treatments they’re testing hope to stop the immune system from attacking the pancreas. Where on this path is the right time to intervene to delay or prevent a diagnosis of Type 1? #dukpc

TrialNet scientists have seen there’s a key phase - just before the symptoms of #Type1diabetes appear - when there is a rapid progression in immune activity and the destruction of insulin-producing cells. If we could treat people at this point it could be game changing. #dukpc

You can see here there are a lot of studies going on at ‘stage 3’, just before diagnosis. But scientists are also moving even further back and testing if they could act to prevent #Type1diabetes before there have been any signs of changes in the immune system. #dukpc

We’ve also learnt that progress along the path to #Type1diabetes isn’t the same for everyone. If you’re younger, things move quicker. But adults move through the different stages much more slowly. #dukpc

TrialNet also screens relatives of people with #Type1diabetes, who we know are at higher risk, for signs that they are on the path to Type 1. This screening has real benefits - reducing risk of DKA and improving blood glucose control. #dukpc

But treatments that re-educate the immune system aren’t just being explored to prevent #Type1diabetes.

When 1st diagnosed you’ve still got quite a few surviving beta cells. @parthnarendran has reviewed the evidence we have on treatments that hope to protect these cells #dukpc

Immunotherapies are an exciting prospect in this area, and where the bulk of the #research is. But aren’t the only possibilities.

Studies have looked at whether tightly controlling your blood glucose levels could help preserve beta cells. #dukpc

Weaving back to prevention. Prof John Todd is telling us about POInT - a global trial that’s finding out if giving oral insulin to babies, who have a high genetic risk of #Type1diabetes, could stop them from developing the condition in later life. #dukpc

It’s following on from recent discoveries about peanut allergies. The idea is giving tiny amount of insulin for the 1st 3 years of a child’s life could help their immune system to tolerate insulin. #dukpc

The trial has recently started recruiting in the UK. And will run for 7 years. A while to wait yet before we get any results. But Prof Todd highlights the importance of consistent research funding to be able to take these vital steps towards prevention strategies. #dukpc