Prevention versus intervention of type 1 diabetes

• Pathogenesis of type 1 diabetes (T1D) is discussed.
• Classification of prevention trials is discussed in relation to T1D.
• Proposed explanations for failures of prevention trials in T1D are discussed.
• Ethical issues regarding clinical trials in T1D are discussed.
• The potential impact of ethical issues on future trials in T1D is discussed.

Type 1 diabetes (T1D) is a cell-mediated autoimmune disease. New cases of T1D are on the increase and exogenous insulin therapy is the only intervention regularly initiated for T1D patients. Though tremendous strides have been made in prediction of T1D, prevention and intervention strategies have not experienced the same success. In this review, we will discuss some possible reasons why new intervention therapies for T1D have not been implemented into the mainstream treatment regimen for T1D patients. We will also discuss potential caveats for why prevention and intervention trials in T1D may not have experienced the same success as prediction trials.