Type 1 diabetes mellitus

Abstract

Type 1 diabetes mellitus (T1DM), also known as autoimmune diabetes, is a chronic disease characterized by insulin deficiency due to pancreatic β-cell loss and leads to hyperglycaemia. Although the age of symptomatic onset is usually during childhood or adolescence, symptoms can sometimes develop much later. Although the aetiology of T1DM is not completely understood, the pathogenesis of the disease is thought to involve T cell-mediated destruction of β-cells. Islet-targeting autoantibodies that target insulin, 65 kDa glutamic acid decarboxylase, insulinoma-associated protein 2 and zinc transporter 8 - all of which are proteins associated with secretory granules in β-cells - are biomarkers of T1DM-associated autoimmunity that are found months to years before symptom onset, and can be used to identify and study individuals who are at risk of developing T1DM. The type of autoantibody that appears first depends on the environmental trigger and on genetic factors. The pathogenesis of T1DM can be divided into three stages depending on the absence or presence of hyperglycaemia and hyperglycaemia-associated symptoms (such as polyuria and thirst). A cure is not available, and patients depend on lifelong insulin injections; novel approaches to insulin treatment, such as insulin pumps, continuous glucose monitoring and hybrid closed-loop systems, are in development. Although intensive glycaemic control has reduced the incidence of microvascular and macrovascular complications, the majority of patients with T1DM are still developing these complications. Major research efforts are needed to achieve early diagnosis, prevent β-cell loss and develop better treatment options to improve the quality of life and prognosis of those affected.

Prevalence of diagnosed type 1 and type 2 diabetes among US adults in 2016 and 2017: population based study

“…Type 2 diabetes–the predominant subtype of diabetes—mostly develops in adulthood 1112. In contrast, type 1 diabetes usually develops in childhood and is considered rare among adults 111314. Although previous studies in the United States151617 and elsewhere18 have reported the prevalence of diabetes among adults on the basis of national health surveys,151617 little is known about the prevalence by diabetes subtypes (eg, type 1 and type 2 diabetes) in adulthood.…”

“…With the continuing improvement in treatment of type 1 diabetes,1113 more children with this form of diabetes are expected to survive to adulthood.…”

Diabetes and Metabolic Syndrome in Survivors of Childhood Cancer

“…Indeed, type 2 diabetes is characterized by hyperglycemia and insulin resistance, often in the setting of overweight and obesity [54, 55], while type 1 diabetes is distinguished by autoimmune destruction of the pancreatic β-cells with resultant insulin deficiency requiring lifelong insulin treatment [56]. …”

Decreased levels of keratin 8 sensitize mice to streptozotocin‐induced diabetes

“…K8 +/− mouse blood glucose levels were also higher than in K8 +/+ mice after STZ treatment at the two‐week time point (Figure 3B) and remained at a higher level in K8 +/− mice until the end of the experiment (not shown). Moreover, polyuria, which is an indication of the severity of diabetes,25 was significantly increased in STZ‐treated diabetic K8 +/− compared with K8 +/+ mice at 34 days post‐STZ treatments (Figure 3c), confirming the more severe diabetic condition in these mice. In untreated control mice, no differences in urine volume were seen between the genotypes (Figure 3C).…”