Mitogen-activated protein kinases (MAPKs) and heat shock proteins (HSPs) are ubiquitous proteins that function within T cells in both normal and stress-related pathophysiological states, including type 1 diabetes. The nonobese diabetic (NOD) mouse spontaneously develops T cell-mediated autoimmune pancreatic beta cell destruction that is similar to type 1 diabetes in humans. Because p38 MAPKs have been shown to modulate T cell function, we studied the effects of a p38␣ MAPK-selective inhibitor, indole-5-carboxamide (SD-169), on the development and progression of type 1 diabetes in the NOD mouse. In preventive treatment studies, SD-169 significantly reduced p38 and HSP60 expression in T cells of the pancreatic beta islets. Following treatment, the incidence of diabetes as determined by blood glucose levels was significantly lower, and immunohistochemistry of pancreatic beta islet tissue demonstrated significant reduction in CD5 ϩ T cell infiltration in the SD-169 treatment group as compared with untreated NOD mice. In therapeutic studies using mildly and moderately hyperglycemic NOD mice, SD-169 treatment lowered blood glucose and improved glucose homeostasis. Furthermore, following cessation of SD-169 treatment, NOD mice showed significant arrest of diabetes. In conclusion, we report that this p38␣-selective inhibitor prevents the development and progression of diabetes in NOD mice by inhibiting T cell infiltration and activation, thereby preserving beta cell mass via inhibition of the p38 MAPK signaling pathway. These results have bearing on current prophylactic and therapeutic protocols using p38␣-selective inhibitors in the prediabetic period for children at high risk of type 1 diabetes, in the honeymoon period, and for adults with latent autoimmune diabetes.Type 1 diabetes is a multifactorial disease in which autoimmunity plays a prime role. The disease becomes clinically manifest when the majority of endocrine beta cells have been destroyed in a T cell-mediated process (Yoshida and Kikutani, 2000). Methods that predict the development of type 1 diabetes may allow the evaluation of pharmacological treatment strategies that halt or even prevent beta cell destruction (Debussche et al., 1993;Keymeulen and Somer, 1993;Mahon et al., 1993;Ryu et al., 2001;Shapiro et al., 2002). Following the initiation of insulin therapy, 60 to 80% of patients with type 1 diabetes will experience a transient remission known as the honeymoon period (Keymeulen and Somer, 1993), and therapeutic strategies have been described to prolong this period by slowing the ongoing self-destruction of the insulin-producing beta cells (Hosker and Turner, 1982;Heinze and Thon, 1985;Crump, 1987;Palmer and McCulloch, 1990;Herold et al., 2002;Shapiro et al., 2002). Between 5 and 30% of adults presenting with mild hyperglycemia suggestive of type 2 diabetes may actually have a slowprogressive form of type 1 diabetes designated latent autoimmune diabetes of adults (Casteels et al., 1998). Immunosuppressive agents prevent the onset of type 1 diab...