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GAD-alum + vitamin d is a combination therapy consisting of aluminum-formulated glutamic acid decarboxylase (GAD65) administered via intralymphatic injection together with oral supplementation of vitamin D. The primary mechanism is antigen-specific immunomodulation aimed at preserving endogenous insulin secretion in patients with recent-onset type 1 diabetes. GAD-alum acts as an autoantigen to induce immune tolerance against pancreatic beta cell antigens, while vitamin D is thought to have additional immunomodulatory effects that may enhance the efficacy of antigen-specific therapy. This combination has been studied primarily in individuals carrying the HLA DR3-DQ2 haplotype and has shown potential for disease modification by preserving C-peptide levels in this genetically defined subgroup[1][2][5].
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