Prevention of Type 1 Diabetes
Coordinators:
Carolin Daniel | Ezio Bonifacio | Anette-Gabriele Ziegler
Recognizing, understanding and preventing type 1 diabetes (T1D) at an early stage – that is the aim of the T1D Academy. Based on innovative research, the Academy wants to find out how the disease develops, which risk factors play a role and how the body’s own defenses can be influenced so that the insulin-producing cells of the pancreas remain protected.
The chronic autoimmune disease T1D usually begins in childhood or adolescence. It is caused by the immune system attacking and destroying the insulin-producing beta cells in the pancreas. Both genetic factors and environmental influences play a role in the development of the disease. The Type 1 Diabetes Academy aims at better understanding the underlying mechanisms of the disease and at developing innovative therapeutic approaches that specifically modulate the immune system. The T1D Academy sets its priorities specifically on promoting the clinical implementation of new findings.
Key areas of research
- Identification of markers for risk stratification and definition of T1D subtypes.
- Development of immunomodulatory therapy strategies that delay or prevent the onset of the disease.
- Identification of environmental risk factors.
Identification of risk groups
DZD researchers have developed a test (genetic risk score) for detecting an increased risk of T1D in infants at an early stage and introduced it into various population screenings in Europe. More than 500,000 children have already been tested for genetic risk markers in studies conducted by the international consortium Global Platform for the Prevention of Autoimmune Diabetes (GPPAD). Families with affected children can take part in clinical prevention studies investigating the preventive effect of oral insulin, probiotics or vaccinations against COVID. Around 2000 families are already taking advantage of this offer.
To date, more than 185,000 children have been screened for islet autoantibodies as part of the Fr1da study, and children with early-stage T1D have been classified, trained and regularly monitored. Early detection helps to prevent metabolic derailment and treat T1D more effectively.
Characterization of subtypes of type 1 diabetes
The analysis of samples and data from the DiMelli study and the Diabetes Patient History Documentation (Diabetes-Patienten-Verlaufsdokumentation, DPV) resulted in the characterization of seven different T1D subtypes. These subtypes differ in genetics, inflammatory markers, family history of diabetes, insulin treatment, insulin sensitivity and insulin autoimmunity. The identification of these subtypes enables a more precise prediction, prevention and treatment of T1D.
Development of therapy strategies
In autoimmune diseases such as T1D, the function of regulatory T cells (Tregs), which prevent excessive immune reactions in a healthy person, is restricted. DZD researchers are investigating the molecular basis that contributes to these impairments. Several relevant signaling pathways have already been identified, forming the basis of the development of first promising therapeutic approaches.
Publications
Lugar et al. SARS-CoV-2 Infection and Development of Islet Autoimmunity in Early Childhood. JAMA (2023). https://doi.org/10.1001/jama.2023.16348
Warncke, Weiss et al. Elevations in blood glucose before and after the appearance of islet autoantibodies in children. JCI (2022). https://doi.org/10.1172/JCI162123
Tutino et al. Genetics of circulating proteins in newborn babies at high risk of type 1 diabetes. Nat Com (2025). https://doi.org/10.1038/s41467-025-58972-3
Apaolaza P et al. Islet expression of type I interferon response sensors is associated with immune infiltration and viral infection in type 1 diabetes. Sci Adv (2021). https://doi.org/10.1126/sciadv.abd6527
Becker M et al. Niche-specific control of tissue function by regulatory T cells — Current challenges and perspectives for targeting metabolic disease. Cell Metab (2024). https://doi.org/10.1016/j.cmet.2023.12.019
GPPAD
The Global Platform for the Prevention of Autoimmune Diabetes (GPPAD) brings together several academic research institutions and hospitals in Europe. GPPAD aims to establish an international infrastructure for studies dedicated to preventing the development of type 1 diabetes. All GPPAD studies are led by the DZD partner Helmholtz Zentrum München.
