For a person with high-risk genes and all three autoantibodies, the risk of developing diabetes in the next five years is greater than 50 percent, Schatz said.
We hope that learning about the underlying immune events that set the stage for diabetes will help us identify ways to rein in the autoimmune attack on beta cells, he said.
Animal studies have also suggested that insulin taken orally might even prevent type 1 diabetes. Some scientists think that introducing insulin via the digestive tract induces tolerance, a quieting of the immune system.
First- and second-degree relatives of people with type 1 diabetes who may be at risk are initially being screened through TrialNets natural history study, which is examining the immune and metabolic events that precede diabetes symptoms. Screening involves a simple blood test. Individuals enrolled in the natural history study are closely monitored for diabetes development and may be eligible to participate in the oral insulin trial or future studies that try to arrest the autoimmune process.
To lower blood sugar levels once diabetes occurs, patients need three or more insulin injections a day or treatment with an insulin pump. To prevent complications, they must regularly monitor their blood glucose, striving for a range that is as close to normal as possible.
Other diabetes studies under way at UF include a trial aimed at preserving insulin production in people recently diagnosed with type 1 diabetes, who often still have a supply of functioning beta cells. If these remaining beta cells can be protected with the help of insulin injections, more patients would be able to tightly control their blood glucose, preventing or delaying damage to the eyes, nerves, kidneys, heart and blood vessels.