MMPAD Milan Meeting Report

5 European Roadshow - Milan, 29 June 2018 MEETING REPORT PREDICTION AND PREVENTION OF TYPE 1 DIABETES IN CHILDREN Presented by Professor Francesco Chiarelli - University of Chieti Globally there are ~550,000 children with T1D and annually there are ~85,000 new diagnoses. Current estimates predict increases in incidence of ~3% per year. Diabetes can lead to serious acute and chronic complications including ketoacidosis, hypo- and hyperglycaemia, retinopathy, macrovascular complications, nephropathy and neuropathy, which in the long term can lead to disability and death . 1 The pathogenesis of T1D is complex with the fundamental event being the destruction of pancreatic beta-cells via autoimmune reactions. However, what causes the immunological attack is not known, although there are several hypotheses being studied. These include the role of some viruses such as Coxsackie viruses, a reduced immunological tolerance linked to an altered activity of T-regulatory cells, and the implication of cytokines, such as IL-2 and IL-10 . 2 Reflection: It is possible to predict the onset of T1D There are markers sufficiently reliable in predicting the onset of the disease: the most important are GADA and IA-2, and anti-insulin antibodies, particularly useful for the diagnosis of prediabetes in early childhood. Fig. 1. Immunological markers of humoral autoimmunity against beta-cells Skyler J et al., Diabetes 2009 It is important to know that the presence of autoantibodies is considered to be already an initial phase of T1D, in accordance with the indications of the JDRF (Juvenile Diabetes Research Foundation), the ADA (American Diabetes Association) and the Endocrine Society. An extract from Professor Chiarelli ‘s presentation is available here