Immunotherapy at clinical diagnosis of insulin-dependent diabetes: an approach still worth considering.

Immunointervention at the time of clinical diagnosis of insulin-dependent diabetes has been adopted in many centers throughout the world, with the aim of inducing and maintaining clinical remission (for example, reduction of insulin replacement therapy with normalization of metabolic parameters). Several approaches have been considered, ranging from the use of different kinds of immunosuppression to the use of free oxygen radical scavengers. Although the period of latency before the onset of overt hyperglycemia should be regarded as the most favorable time for any sort of immunointervention, adjuvant treatment at diagnosis (in addition to intensive insulin therapy) may offer clinical advantages in the long term. Thus, maintenance of some residual beta-cell function as a result o f such an approach may improve metabolic control and help to prevent the insurgence of late diabetic complications.