New advances in type 1 diabetes

Abstract

Type 1 diabetes is an autoimmune condition resulting in insulin deficiency and eventual loss of pancreatic β cell function requiring lifelong insulin therapy. Since the discovery of insulin more than 100 years ago, vast advances in treatments have improved care for many people with type 1 diabetes. Ongoing research on the genetics and immunology of type 1 diabetes and on interventions to modify disease course and preserve β cell function have expanded our broad understanding of this condition. Biomarkers of type 1 diabetes are detectable months to years before development of overt disease, and three stages of diabetes are now recognized. The advent of continuous glucose monitoring and the newer automated insulin delivery systems have changed the landscape of type 1 diabetes management and are associated with improved glycated hemoglobin and decreased hypoglycemia. Adjunctive therapies such as sodium glucose cotransporter-1 inhibitors and glucagon-like peptide 1 receptor agonists may find use in management in the future. Despite these rapid advances in the field, people living in under-resourced parts of the world struggle to obtain necessities such as insulin, syringes, and blood glucose monitoring essential for managing this condition. This review covers recent developments in diagnosis and treatment and future directions in the broad field of type 1 diabetes.

Chronic intermittent fasting impairs β-cell maturation and function in adolescent mice

“…Reduction in cellular nutrient flux may lead to an atrophic cellular remodeling. Atrophic responses are generally associated with secretory malfunction 26,27 , an early indication of β-cell failure 28,29 , including altered pro-insulin processing, elevated pro-insulin levels, a reduction in secretory granules, and β-cell deterioration 27,28 . These pathological responses can be triggered by genetic predisposition (lowered secretory capacity) and environmental stressors.…”

Elucidating T cell dynamics and molecular mechanisms in syngeneic and allogeneic islet transplantation through single-cell RNA sequencing

“…Islet transplantation has become a promising therapy for certain endocrine disorders, particularly type 1 diabetes mellitus (T1DM), which affects approximately 1.6 million Americans, and the incidence of this disease continues to increase globally ( 1 – 3 ). Despite advances in insulin therapy and continuous glucose monitoring, achieving optimal glycemic control remains a challenge for many patients, leading to long-term complications and increased mortality ( 4 , 5 ).…”

Why hospital capacity is more complex than bed capacity

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