[ Diabetes Solutions ]

Global Platform for the Prevention of Autoimmune Diabetes (GPPAD): What is GPPAD


1,25 dihydroxyvitamin D3, the active form of vitamin D, has immunomodulatory properties in vitro and in vivo. Distinct types of T helper cells (TH1 and TH2) have been characterised based on their cytokine secretion profiles following activation. This holds important implications for our understanding of the factors that modify the rate of progression through the disease prodrome to clinical diabetes and for our management of the disease. Mice were treated with mouse interferon-beta (IFN-beta, 1 x 105 IU/day), a new 14-epi-1,25-(OH)2D3-analogue (TX 527, 5 microg/kg/day) and cyclosporin A (CsA, 7.5 mg/kg/day) as single substances and in combinations. Of them, 46 (9.2%) were found to have LADA. Significant upregulation of the CD44 and CD122 markers as compared to healthy male and female mice characterized the phenotype of diabetogenic CD8+ T cells in diabetic male mice. In a separate study, thyroid function tests of young diabetic patients revealed that about 1% had Grave’s disease (autoimmune hyperthyroidism) and about 7% had Hashimoto’s disease (autoimmune thyroiditis).

Median time to insulin was 16.15 months (interqartile range 6.7–25.5) in centers with GADA testing compared with 45.6 months (29.5–61.8) in centers without routine GADA testing (P < 0.002). Those who had or developed autoimmune diabetes in adulthood had less central obesity, lower triglycerides, and higher HDL cholesterol than those with type 2 diabetes. GPPAD will facilitate this by establishing linked early genetic testing and follow-up programs, such as the Freder1k study in Saxony Germany. Importantly, the GPPAD vision requires the participation and engagement of clinicians, scientists, government, private enterprise, laypersons, and the public at large. Prevention is indeed a global effort, and GPPAD’s success will rely on its ability to integrate and inform all these parties of the need and the means to bring about prevention of a lifelong disease that, in western countries, affects 5 in every 1000 children.

Tags: , ,
[ Herbal Remedies ]

Global Platform for the Prevention of Autoimmune Diabetes (GPPAD): What is GPPAD?


Polyendocrine syndrome type 1 (APECED) is an ultra-rare condition affecting only around 500 people in the world, but it could tell us about the causes of type 1 diabetes, and could help inform the development of a type 1 treatment. Studies in IDDM 5 have lead to the discovery of a novel polymorphism 163 A–>G, of SUMO4 (small ubiquitin-related modifier) gene, associated with risk to T1DM in Asians, but not in Caucasians. However, there is a group of phenotypic adult type 2 diabetic patients (∼10%) who have islet autoantibodies similar to type 1 diabetes. Furthermore, cells cross-reactive between viral and self-antigens might express low avidity T cell receptors and only be present transiently in the blood of affected individuals. The clinical screening tool was developed to aid primary care physicians and diabetes nurse practitioners to consider the pathophysiological process of autoimmune β-cell destruction. Risk factors thus seem to be largely similar to those of type 2 diabetes which suggests a partially shared pathogenesis, in spite of the autoimmune nature of LADA. At four days of age he had high serum concentrations of insulin and glutamic acid decarboxylase autoantibodies, whereas the values in his mother were normal.

Type 1 diabetes is genetically determined as shown by family, twin, and genetic studies. In contrast, patients with low GADA titers do not seem to have any disadvantage when managed as type 2 diabetic patients (GADA negative). GPPAD will facilitate this by establishing linked early genetic testing and follow-up programs, such as the Freder1k study in Saxony Germany. Importantly, the GPPAD vision requires the participation and engagement of clinicians, scientists, government, private enterprise, laypersons, and the public at large. Prevention is indeed a global effort, and GPPAD’s success will rely on its ability to integrate and inform all these parties of the need and the means to bring about prevention of a lifelong disease that, in western countries, affects 5 in every 1000 children.

Tags: , ,