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Although a cure for T1D is currently unavailable, several large international investigations have been designed to evaluate a number of primary and secondary disease interventions. Two are targeted towards unaffected first degree relatives (FDR) in families with an individual with T1D. One is targeted to the general population (GP) of Finland. To determine if individuals are eligible, genetic testing for DQB1 is performed.
For the Trial to Reduce Type 1 Diabetes in Genetically at-Risk (TRIGR) and the Diabetes Prediction and Prevention Project (DIPP), genetic testing is performed as part of newborn screening. Infants who carry high risk DQB1 alleles are eligible to participate. For TRIGR, newborns are randomized to receive either a regular cow’s milk formula or one with hydrolyzed proteins, which is thought to be protective. This study is being conducted in Europe and North America. For DIPP, newborns with high risk DQB1 alleles from the general Finish population are followed until they develop beta cell antibodies. When this occurs, they are randomized to an intervention based on nasal insulin.
New interventions that will be tested in the future will be conducted through T1D TrialNet, a collaborative network of clinical centers and experts in diabetes and immunology. These studies will identify unaffected first degree relatives with beta cell autoantibodies who will be eligible for new interventions. Those who carry the protective DQB1*0602 gene, however, are generally excluded. The first TrialNet intervention study is testing two immunosuppressive agents (Mycophenolate mofetil) alone or in combination with Daclizumab.