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Type 1 diabetes, ageing and frailty: an underexplored intersection
Giuseppe Maltese1,2, Janaka Karalliedde3, Jugdeep Dhesi4,5
1Department of Diabetes and Endocrinology, Epsom and St Helier University Hospitals NHS Trust, London, UK. Giuseppe.maltese@kcl.ac.uk.
Diabetologia
|February 17, 2026
Summary
Type 1 diabetes may accelerate aging, leading to frailty. This review explores the link between type 1 diabetes and frailty, its causes, and potential treatments.
Area of Science:
- Gerontology
- Endocrinology
- Metabolic Disorders
Background:
- Improved life expectancy in type 1 diabetes (T1D) presents new challenges.
- Sustained hyperglycemia and hypoglycemia in T1D may accelerate aging and lead to frailty.
- Frailty is a recognized complication of diabetes, linked to adverse outcomes.
Purpose of the Study:
- To review the evidence linking frailty and T1D.
- To explore the pathophysiological mechanisms of frailty in T1D.
- To discuss assessment, treatment, and future research directions.
Main Methods:
- Literature review of studies on T1D and frailty.
- Analysis of pathophysiological mechanisms.
- Discussion of current assessment and treatment strategies.
Main Results:
- Frailty is increasingly recognized as a complication of T1D.
- Pathophysiology involves hyperglycemia, vascular complications, hormonal changes, sarcopenia, and cognitive decline.
- Most research currently focuses on type 2 diabetes.
Conclusions:
- Frailty is a significant concern in the aging T1D population.
- Further research is needed to fully elucidate the relationship between T1D and frailty.
- Developing effective assessment and treatment strategies for frailty in T1D is crucial.
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