Autoimmune diseases like type 1 diabetes (T1D) are on the rise -- and no one quite knows why. Despite decades of research costing billions of dollars, a cure for T1D remains elusive and unlikely for many years to come. Facing that challenge, much of the research to date has focused on improving conditions for the millions already living with this chronic illness.
But what if we could prevent a mysterious and severe condition like T1D before it even arises?
A slate of studies has been asking that question. Last month, a small clinical trial in Germany found that daily doses of oral insulin for children susceptible to T1D can bring on vaccine-like immune responses, giving rise to the hope that such interventions could eventually prevent T1D. Meanwhile, a large research initiative across Australia is assessing genetically at-risk babies to identify environmental triggers that may influence the development of the disease early in life. And several observational studies supported by NIH and others have been shedding light on how environmental factors like diet and lifestyle may contribute to the onset of T1D.
These studies are encouraging, and they are just the tip of the iceberg of what we have to learn. Existing efforts in prevention science have uncovered some critical pieces of the puzzle that open the door to emerging opportunities, but it will take a sustained commitment to this research and a collaborative effort to support future intervention studies in order to accelerate the path to prevention.
That's why we've launched a new T1D initiative at the Helmsley Charitable Trust to begin to develop a global infrastructure for preventing this chronic illness. Philanthropy -- as we see it here at Helmsley -- has the unique ability to pursue ambitious, long-term strategies. This new initiative will identify new opportunities for intervention and investigate the early stages of disease development across hundreds of thousands of newborns and children globally. In some cases, these studies are already underway; in others they mark an important new undertaking to understand and prevent T1D -- and ultimately pave the way to future prevention endeavors across other diseases.
One such new undertaking will help researchers in England and Germany lay the groundwork to create a platform for performing intervention trials among the general population -- for the first time at such a large scale. These researchers will have the opportunity to explore safe and cost-effective interventions that could preserve the body's ability to produce insulin. Tapping into their nationalized healthcare infrastructures will open the door to facilitating standardized interventions and data-gathering across both countries. Importantly, their widespread efforts will be able to collect information for a range of other chronic diseases that are also on the rise. It is our hope that this platform will continue to expand and provide a far-reaching, replicable model for other countries and for other diseases.
These studies tap into a new phase of medical research in which data are being collected on a scale previously unimaginable. Today's science, technology and patient engagement are now sufficiently advanced that we have an opportunity to really crack open the 'black box' of how humans develop T1D and other diseases. With the critical help of ongoing recruitment efforts, large numbers of study participants will help us understand mysteries like why only 3-4% of genetically vulnerable individuals actually develop T1D.
New investments in prevention may also have major economic implications for individuals and entire countries. In the case of T1D, recent data show that the prevalence of the disease in people under the age of 20 rose by 23 percent between 2001 and 2009. And looking across both type 1 and type 2 diabetes, the growing costs are estimated to reach more than $500 billion in the U.S. by 2020. We mustn't wait this long.
We may not yet know why some autoimmune diseases like T1D are increasing around the globe, but we do know that, more and more, we have better tools to ask why. By pooling international resources and engaging researchers and other stakeholders, we are strategically looking for answers. The Helmsley Charitable Trust is committed to supporting these prevention efforts and we hope that other organizations will join us.
David Panzirer is a parent of a child with type 1 diabetes and a trustee at the Helmsley Charitable Trust.
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