[Current and future care for diabetes in children: from insulin to immunotherapy]

Area of Science:

• Endocrinology
• Immunology
• Pediatrics

Context:

• Type 1 diabetes (T1D) is an autoimmune disease causing progressive destruction of pancreatic beta cells.
• Epidemiological data indicate a concerning annual increase in T1D incidence.
• Children with new-onset T1D often present with classic symptoms like polyuria, polydipsia, and weight loss.

Purpose:

• To summarize the current understanding of Type 1 diabetes in children.
• To highlight the importance of insulin therapy and emerging immunomodulatory approaches.
• To address the diagnostic significance of monogenic diabetes and the critical transition period in pediatric care.

Summary:

• Type 1 diabetes (T1D) involves autoimmune destruction of insulin-producing beta cells, requiring insulin substitution therapy.
• The incidence of T1D is rising, particularly in children who present with characteristic symptoms.
• Current management focuses on strict insulin adherence, with ongoing research into immunomodulatory treatments and specific therapies for rare monogenic forms.

Impact:

• Emphasizes the need for continued insulin therapy adherence to maintain glycemic control.
• Underscores the importance of investigating novel immunomodulatory strategies for T1D.
• Highlights the critical need for timely diagnosis, especially for monogenic diabetes, and careful management during the transition from pediatric to adult care.