[Type 1 diabetes: an update]

Area of Science:

• Endocrinology
• Pediatric Endocrinology
• Metabolic Diseases

Background:

• Type 1 diabetes (T1D) incidence has increased significantly over 30 years, especially in children and adolescents.
• T1D development involves three stages, and delayed diagnosis can result in life-threatening diabetic ketoacidosis.
• Adult-onset diabetes is often misdiagnosed as type 2 diabetes, highlighting diagnostic challenges.

Purpose of the Study:

• To review the current understanding of T1D incidence, diagnosis, and management across different age groups.
• To emphasize the importance of modern therapeutic approaches for improving glycemic control and preventing complications.
• To highlight the critical need for early detection and management of cardiovascular risk factors in young T1D patients.

Main Methods:

• Review of epidemiological trends in T1D incidence.
• Analysis of diagnostic challenges and common misclassifications.
• Evaluation of current insulin therapy, including insulin pump therapy and continuous glucose monitoring.

Main Results:

• T1D incidence is doubling every 20 years in pediatric populations, with a high rate of diabetic ketoacidosis at diagnosis in Germany.
• Insulin pump therapy and continuous glucose monitoring are increasingly used to enhance glycemic control (time in range 70-180 mg/dl) and reduce glycemic variability.
• Treatment goals include achieving HbA1c below 7% and actively managing cardiovascular risk factors.

Conclusions:

• Effective T1D management requires timely diagnosis and appropriate insulin therapy, regardless of age.
• Advanced technologies like insulin pumps and continuous glucose monitoring significantly improve outcomes for T1D patients.
• Preventing long-term microvascular and cardiovascular complications is paramount for individuals with T1D, including young patients.