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Carla Greenbaum Part 2, Early Signs for Detecting Type 1 Diabetes

In part 2 of this Exclusive Interview, Dr. Carla Greenbaum talks with Diabetes in Control Publisher Steve Freed during the ADA meeting in San Diego, California about early signs for detecting type 1 diabetes, the ability to test for diabetes antibiodies in very young children, and steps to treat the disease early.

Carla Greenbaum, MD is Director of the Diabetes Research Program at Benaroya Research Institute at Virginia Mason in Seattle, WA.

Transcript of this video segment:

Steve Freed: So, your research, like you said, is not so much per se for a cure for those people that already have it. It’s really meant in some way to help be able to prevent type 1 diabetes. Would that be from the womb? Would that be, you know after 3 years of age? Do we even have an idea when that will take place if you’re successful?

Carla Greenbaum: Sure, so I think it’s very important to recognize that one of the biggest advances since long before my grey hair, has been that now that we follow people for so long, we can actually put people into different stages of disease. So we know that type 1 diabetes starts at stage 1, which is when people have 2 or more antibodies. Now why do we say that? If you have 2 or more antibodies, we now know you will develop clinical type 1 diabetes. Before, we used to say you have 2 or more antibodies, you have a 40% risk over 5 years, etc. But now we’ve followed enough people long enough that we actually know that is a start of disease and we need to treat that just like we treat hypertension. You know we treat high blood pressure. Why do we treat high blood pressure? It’s to prevent stroke or heart attack. We can treat islet autoimmunity. We want to prevent people from getting clinical manifestations of type 1 diabetes. So stage 1 is when people’s glucoses are still normal completely but they have multiple antibodies. Stage 2 is when the glucose is abnormal but not diabetic and they’re not symptomatic and again with multiple antibodies. Stage 3 is what we used to call new onset diabetes. And so all the trials are identifying the people at those early stages. We’re not preventing disease. We’re treating that early disease to prevent having hyperglycemia. Now many of our studies involve children as young as 3 and in fact our natural history study, where we’re following people to see if we can stop and prevent their disease, they can be screened as young as 1. And we can test them for these markers. The different drugs depend on what their ages would be appropriate to test. So study results that will be announced later this week, involved a study that involved children as young as age 3 up to adults in their 40’s. So, we really know that since type 1 diabetes encompasses all ages, that we really need to have a breadth of therapies to try.

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