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Stage-Adapted Disease-Modifying Therapy in Type 1 Diabetes
Chenming Ye1,2, Zhenning Jin1,2, Shen S Hu1,2
1Zhejiang Key Laboratory of Multiomics and Molecular Enzymology, Yangtze Delta Region Institute of Tsinghua University, Zhejiang, China.
Diabetes, Obesity & Metabolism
|August 13, 2026
Summary
A new framework for type 1 diabetes (T1D) treatment adapts therapies to disease stage, considering immune plasticity and beta-cell function. This approach aims to optimize treatment selection and clinical trial design for better outcomes.
Area of Science:
- Immunology
- Endocrinology
- Metabolic Diseases
Background:
- Type 1 diabetes (T1D) is an autoimmune disease characterized by the destruction of insulin-producing beta cells.
- Current T1D management focuses on glycemic control, but disease-modifying therapies are under development.
- Understanding the interplay between immune responses and residual beta-cell function is crucial for effective T1D treatment.
Purpose of the Study:
- To propose a stage-adapted framework for disease-modifying therapy in T1D.
- To integrate immune plasticity and residual beta-cell function into treatment selection.
- To inform combination strategies and clinical trial endpoints for T1D.
Main Methods:
- A narrative review synthesizing evidence from mechanistic, observational, and interventional studies.
- Analysis of data across presymptomatic, recent-onset, and established T1D stages.
- Interpretation of immune modulation, antigen-specific interventions, and beta-cell strategies within disease contexts.
Main Results:
- Therapeutic responsiveness in T1D is influenced by evolving immune plasticity and residual beta-cell function.
- Early T1D offers a window for immune redirection and beta-cell preservation.
- Established T1D with significant beta-cell loss may necessitate beta-cell replacement combined with graft protection.
Conclusions:
- A stage-adapted treatment framework provides a clinically interpretable approach for T1D.
- Integrating disease stage, immune endotype, and beta-cell function can enhance T1D trial design.
- Prospective validation of this framework is warranted for improved T1D management.
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