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Printable Handouts
Navigable Slide Index
- Introduction
- Disclosure
- Incidence rates of type 1 diabetes
- Cause and effect
- Prerequisite 1 – genetic etiology
- Prerequisite 2 – autoantibodies as biomarkers
- Autoantibodies predict clinical onset of diabetes
- Etiology
- Development of autoantibodies is the first primary endpoint in the TEDDY study
- TEDDY study - methods
- Two variants (endotypes)
- Results – parents' questionnaires
- Early virus infection prior to first autoantibody
- Enterovirus B increased the risk for IAA-first
- Gastroenteritis and GADA as the first appearing autoantibody
- Major findings
- Longitudinal metabolome-wide signals prior to the appearance of a first islet autoantibody
- Longitudinal gene expression and T1D progression
- Independent validation: DIPP study
- DIPP study - findings
- Risk of developing T1D-associated autoimmunity declines exponentially with age
- Vaccine against autoimmune diabetes
- Etiology and pathogenesis of T1D
- Enrolled TEDDY subjects
- IAA-first or GADA-first summary
- Type and time of second-appearing autoantibody augments the risk of progression to T1D
- Distinct growth phases in early life associated with the risk of progression from IA to T1D
- Participation in the TEDDY study and risk of DKA
- Residual beta-cell function in diabetic children vs. community controls
- The TEDDY study funding
- Acknowledgements
Topics Covered
- Genetic etiology
- Autoantibodies as biomarkers
- Autoantibodies predict clinical onset of diabetes
- TEDDY study
- DIPP study
- Etiology and pathogenesis of type 1 diabetes
- IAA-first or GADA-first
Links
Series:
- Diabetes in Perspective
- The Immune System - Key Concepts and Questions
- Periodic Reports: Advances in Clinical Interventions and Research Platforms
Categories:
Therapeutic Areas:
Talk Citation
Lernmark, Å. (2023, February 28). What is new in type 1 diabetes? [Video file]. In The Biomedical & Life Sciences Collection, Henry Stewart Talks. Retrieved December 5, 2024, from https://doi.org/10.69645/IKJW2509.Export Citation (RIS)
Publication History
Financial Disclosures
- Prof. Åke Lernmark, Consultant: Diamyd Medicals AB, Stockholm, Sweden ; Grant/Research Support (Principal Investigator): National Institutes of Health, Swedish Council, Juvenile Diabetes Research Foundation.
Other Talks in the Series: The Immune System - Key Concepts and Questions
Other Talks in the Series: Periodic Reports: Advances in Clinical Interventions and Research Platforms
Transcript
Please wait while the transcript is being prepared...
0:00
What Is New in Type 1 Diabetes?
My name is Åke Lernmark.
I am at Lund University,
Clinical Research Center
in Malmö, Sweden.
0:13
My disclosures are
that I am a member
of the Scientific Advisory
Board of Diamyd Medical
in Stockholm, Sweden,
and also the European Advisory
Board of ProventionBio,
in the United States.
0:30
This is the map of
incidence rates
of type 1 diabetes in the world.
The color coding is such that
countries with a high incidence
rate are marked black.
As you can see,
the highest incidence
rates of this disease
are in the Scandinavian
countries,
Saudi Arabia, Algeria,
and North America.
And the disease is increasing
by three to five
percent per year.
It is noted that in all these
countries throughout the world,
only 10 percent have a first-degree
relative with type 1 diabetes.
1:17
The cause and effect are
important to understand
in the research of
type 1 diabetes.
There are two events that
need to be kept in mind
when attempting to understand
the development of
type 1 diabetes.
One event is the trigger
and the other event is the
effect of the trigger.
The first event is
referred to as etiology,
which is defined as the
cause or origin of disease.
It can be divided
into two parts.
One is the genetic etiology,
illustrated by the
family to your right.
As you can see,
there are four children
but only one of the children
will inherit from the parents
the risk of developing
type 1 diabetes.
You inherit the risk,
not the disease.
The other factor is
environmental factors,
and I'm illustrating that with
three different types of viruses,
but it could also be other
environmental factors
yet to be determined.
Pathogenesis is the natural
progression of the disease
that will take place once the trigger
has initiated the autoimmunity
against the pancreatic
beta cells.
The diagnosis of type 1
diabetes is a late endpoint
after years of
symptom-free disease,
which is eradicating the
pancreatic islet beta cells.
The result of the pathogenesis
leading to the diagnosis
is that the patient is going to
require daily insulin therapy
because most of the beta cell
and the beta cell
function is lost.