From pumps to prevention: recent advances in the treatment of type 1 diabetes

Jennifer Sherr1, Eda Cengiz, William V Tamborlane

  • 1Department of Pediatrics, Yale University School of Medicine, New Haven, CT, United States. Jennifer.sherr@yale.edu

Insights

Recent advancements in type 1 diabetes mellitus (T1DM) treatment for children include artificial pancreas technology and new medications. Research also explores immunomodulators to address the autoimmune cause of T1DM.

Area of Science:

  • Pediatric Endocrinology
  • Immunology
  • Biomedical Engineering

Background:

  • Type 1 diabetes mellitus (T1DM) management in pediatric patients has evolved significantly.
  • Technological innovations have enhanced insulin delivery and glucose monitoring capabilities.

Purpose of the Study:

  • To review advancements in T1DM treatment for pediatric patients.
  • To discuss the development of artificial pancreas technology.
  • To explore new therapeutic strategies targeting the autoimmune basis of T1DM.

Main Methods:

  • Review of technological advancements in continuous subcutaneous insulin infusion (CSII) and continuous glucose monitoring (CGM).
  • Analysis of initial studies on artificial pancreas systems.
  • Examination of novel rapid-acting insulins and immunomodulatory agents.

Main Results:

  • CSII and CGM have improved insulin delivery and glucose monitoring, paving the way for artificial pancreas development.
  • New rapid-acting insulins offer enhanced glycemic control.
  • Immunomodulators show potential for T1DM prevention and intervention by targeting autoimmune processes.

Conclusions:

  • Technological integration, such as the artificial pancreas, represents a major step forward in pediatric T1DM care.
  • Pharmacological and immunological approaches are expanding treatment options for T1DM.
  • Future research directions include optimizing artificial pancreas systems and refining immunotherapies.

Related Concept Videos

Diabetes: Management and Pharmacotherapy01:15

Diabetes: Management and Pharmacotherapy

The therapy for diabetes aims to alleviate hyperglycemia-related symptoms, prevent acute metabolic decompensation, and reduce chronic end-organ complications. Glycemic control is evaluated through short-term (self-monitoring, continuous glucose monitoring) and long-term (A1c, fructosamine) metrics, enabling near real-time tracking of blood glucose levels and reflecting glycemic control over specific time frames.
Insulin remains the cornerstone of treatment for most patients with type 1 and many...
Diabetes Mellitus: Overview and Type I Subtype01:22

Diabetes Mellitus: Overview and Type I Subtype

Diabetes mellitus is a chronic metabolic disorder characterized by high blood glucose levels due to inadequate insulin production, insulin resistance, or both. The condition affects millions worldwide and can significantly impact their health and quality of life.
Type 1 diabetes is an autoimmune disease in which the immune system mistakenly attacks and destroys the insulin-producing beta cells in the pancreas. As a result, the body is unable to produce sufficient insulin, and individuals with...
Diabetes Mellitus: Type 2 and Gestational01:22

Diabetes Mellitus: Type 2 and Gestational

Type 2 diabetes, characterized by insulin resistance, arises when the insulin receptors on cells lose responsiveness to insulin, diminishing the cell's capacity to take up glucose, resulting in elevated blood glucose levels. To receive a diagnosis of Type 2 diabetes, a series of blood glucose tests are necessary to assess whether the blood glucose falls within normal parameters. If the result is out of the normal range, a patient may be diagnosed as prediabetic or diabetic, depending on the...
Type I Diabetes II: Pathophysiology01:26

Type I Diabetes II: Pathophysiology

Type 1 diabetes mellitus arises from an immune-mediated destruction of pancreatic β-cells, resulting in an absolute deficiency of insulin. This process develops in genetically susceptible individuals when autoimmunity, environmental exposures, and immunologic dysregulation converge to trigger a targeted attack on the insulin-producing cells of the pancreas. The β-cells are located within the islets of Langerhans and are essential for regulating blood glucose by facilitating cellular uptake of...
Type I Diabetes I: Introduction01:12

Type I Diabetes I: Introduction

Type 1 diabetes mellitus is a chronic metabolic disorder characterized by an absolute deficiency of insulin resulting from the autoimmune destruction of pancreatic β-cells. Although it can occur at any age, it is most commonly diagnosed in childhood, adolescence, or early adulthood. The loss of insulin production impairs cellular glucose uptake, resulting in persistent hyperglycemia and necessitating lifelong insulin therapy.Autoimmune Destruction of β-CellsThe hallmark of type 1 diabetes is an...
Type II Diabetes II: Pathophysiology01:24

Type II Diabetes II: Pathophysiology

PathophysiologyType 2 diabetes mellitus (T2DM ) is a chronic metabolic disorder characterized by insulin resistance and progressive pancreatic β-cell dysfunction, leading to impaired glucose homeostasis. It results from interactions among genetic predisposition, environmental factors, and metabolic stressors, such as overnutrition and a sedentary lifestyle.Insulin Resistance and Glucose DysregulationEarly T2DM involves insulin resistance in skeletal muscle, adipose tissue, and the liver.