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Revista chilena de pediatría

versión impresa ISSN 0370-4106


GARCIA B., Hernán. Risk factors and prevention in diabetes mellitus type 1: an update. Rev. chil. pediatr. [online]. 2001, vol.72, n.4, pp.285-291. ISSN 0370-4106.

Insulin dependent diabetes mellitus (IDDM) or type 1 is the result of a long immunological process resulting in destruction of pancreatic islet beta cells. Inspite of medical advances a cure for the disease has not been achieved. This prompts the importance of attempts to prevent the disease in first degree relatives whose risk of developing IDDM is 20 times greater than the general population. Any attempt to modify the immune system that may alter the disease´s natural history must first identify susceptibles individuals. To this end the presence of anti-islet antibodies is determined. In those who tested positive (35%) it is measured the first phase of insulin secretion in response to an iv glucose load. Individuals with a greater risk of developing IDDM are those who are antibody positive and a FPIR of less than the 10th centile of the reference population. This protocol has been applied to first degree relatives of patients with IDDM in 2 controlled prospective multicentre clinical trials taking place at this moment. The European trial (ENDIT) is using nicotinamide and has recluted more than 40,000 subjects, while the American protocol, the Diabetes Prevention trail of DM type 1 (DPT-1) use oral or subcutaneous insulin according to the risk of developing IDDM. In this trial are participating more than 80,000 subjects, the results of which are expected in 2003-4. There are hopes that the results of this trials help to answer the question, if it is possible to alter the biological destiny of a person, and prevent or retard the development of IDDM in susceptible individuals.

Palabras clave : diabetes mellitus; prevention; insulin-dependent diabetes.

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