Diagnosis and treatment of type 1 diabetes at the dawn of the personalized medicine era

Abstract

Type 1 diabetes affects millions of people globally and requires careful management to avoid serious long-term complications, including heart and kidney disease, stroke, and loss of sight. The type 1 diabetes patient cohort is highly heterogeneous, with individuals presenting with disease at different stages and severities, arising from distinct etiologies, and overlaying varied genetic backgrounds. At present, the “one-size-fits-all” treatment for type 1 diabetes is exogenic insulin substitution therapy, but this approach fails to achieve optimal blood glucose control in many individuals. With advances in our understanding of early-stage diabetes development, diabetes stratification, and the role of genetics, type 1 diabetes is a promising candidate for a personalized medicine approach, which aims to apply “the right therapy at the right time, to the right patient”. In the case of type 1 diabetes, great efforts are now being focused on risk stratification for diabetes development to enable pre-clinical detection, and the application of treatments such as gene therapy, to prevent pancreatic destruction in a sub-set of patients. Alongside this, breakthroughs in stem cell therapies hold great promise for the regeneration of pancreatic tissues in some individuals. Here we review the recent initiatives in the field of personalized medicine for type 1 diabetes, including the latest discoveries in stem cell and gene therapy for the disease, and current obstacles that must be overcome before the dream of personalized medicine for all type 1 diabetes patients can be realized.

Type 1 diabetes mellitus in pediatric age group

“…[ 15 16 ] It has to be stressed that how the course of the disease will progress is also based on individualization. [ 12 17 18 ] Therefore, neither the pathogenesis nor the treatment should be based on “one for all.”[ 19 ]…”

Limb Prostheses: Industry 1.0 to 4.0: Perspectives on Technological Advances in Prosthetic Care

“…A wide range of approaches to improving the management and treatment of diabetes is being pursued, crossing the spectrum from apps to allow diabetics to better manage their condition, for example by tracking what they are eating to medical device-based approaches such as continuous glucose monitoring and insulin pumps, which sit alongside surgical innovations such as islet transplantation. Finally, there is the emergence of personalized medicine approaches ( 67 ), with a large-scale Swedish study recently reporting improved health in Type 1 diabetics, including a 40% decline in amputation, when using a personalized medicine approach ( 68 ). These multimodal and technical advances are encouraging for diabetics and while reduced amputation rates indicate success, this will reduce the number of lower limb prostheses required in developed nations, which in turn will impact current prosthetic business models.…”

Omnipod® Insulin Management System - "patch-pump", as a breakthrough in the treatment of type 1 diabetes

“…W celu uniknięcia związanych z chorobą zaburzeń metabolicznych (hiperglikemia z kwasicą ketonową, śpiączka cukrzycowa, hipoglikemia) terapia insuliną powinna być zaplanowana w taki sposób, aby ich ryzyko było jak najmniejsze [1,3]. Często wiąże się to z koniecznością wielokrotnych podaży podskórnych w ciągu dnia [4]. W ostatnim czasie w celu poprawy satysfakcji, komfortu i funkcjonowania insulinozależnego pacjenta z cukrzycą typu 1 skonstruowano "smart pompy".…”