WHAT IS GPPAD?
The Global Platform for the Prevention of Autoimmune Diabetes (GPPAD) was initiated in 2015. Its goal is to provide an international infrastructure that will enable type 1 diabetes primary prevention trials. These clinical trials are built around programs that identify infants with an elevated genetic risk of developing type 1 diabetes, and will aim to reduce the incidence of clinical diabetes in children.
GPPAD’s long-term vision is to stop the trend of an increasing incidence of childhood type 1 diabetes. There must be global action built around a platform that coordinates controlled prevention trials. The GPPAD vision requires the participation and engagement of clinicians, scientists, government, 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 4 in every 1000 children.
The effort will be focused on prevention of the autoimmunity that precedes and destroys the insulin-producing beta cells in the pancreas, eventually leading to type 1 diabetes. Any intervention aiming to prevent type 1 diabetes therefore has to start in infancy or earlier to avert the autoimmunity that often presents at 9 to 24 months of age. GPPAD will facilitate this by establishing screening programs for the early detection of an increased genetic risk of type 1 diabetes in newborns, such as the INGR1D (Investigating Genetic Risk of type 1 Diabetes) study in the Oxford-Thames Valley region.
Simple genetic testing can identify newborns whose risk of developing the early signs of type 1 diabetes is 1 in 10, compared to the general population risk of 1 in 250. Families of babies at increased risk of type 1 diabetes can participate in a clinical study that will test whether oral insulin can prevent autoimmunity and type 1 diabetes.