New frontiers in the treatment of type 1 diabetes

Warshauer, Jeremy T.; Bluestone, Jeffrey A.; Anderson, Mark S.

doi:10.1016/j.cmet.2019.11.017

Cited by 259Diabetes and associated disordersDiabetes Management and ResearchPancreatic function and diabetes

New frontiers in the treatment of type 1 diabetes

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Warshauer, Jeremy T., Bluestone, Jeffrey A., Anderson, Mark S.·2020·Cell Metabolism

DOI 10.1016/j.cmet.2019.11.017PMC PMC6986815

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Abstract

Type 1 diabetes is an autoimmune disease caused by the immune-mediated destruction of pancreatic β-cells that results in lifelong absolute insulin deficiency. For nearly a century, insulin replacement has been the only therapy for most people living with this disease. Recent advances in technology and our understanding of β-cell development, glucose metabolism, and the underlying immune pathogenesis of the disease have led to innovative therapeutic and preventative approaches. A paradigm shift in immunotherapy development towards the targeting of islet-specific immune pathways involved in tolerance has driven the development of therapies that may allow for the prevention or reversal of this disease while avoiding toxicities associated with historical approaches that were broadly immunosuppressive. In this review, we discuss successes, failures, and emerging pharmacological therapies for type 1 diabetes that are changing how we approach this disease from improving glycemic control to the ‘holy grail’ of disease prevention.

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Although several islet autoantibodies have been detected in individuals with type 1 diabetes, and these have prognostic value in individuals at high risk of type 1 diabetes, routine measurement of islet autoantibodies has limited use outside of clinical studies.
“Although several islet autoantibodies have been detected in individuals with type 1 diabetes, and these have prognostic value in individuals at high risk of type 1 diabetes, routine measurement of islet autoantibodies has limited use outside of clinical studies (410).”
From Guidelines and Recommendations for Laboratory Analysis in the Diagnosis and Management of Diabetes Mellitus (2023) · cites this paper as [410]
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Proinsulin Secretion Is a Persistent Feature of Type 1 Diabetes
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Evidence That Nasal Insulin Induces Immune Tolerance to Insulin in Adults With Autoimmune Diabetes
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Autologous hematopoietic stem cell transplantation and conventional insulin therapy in the treatment of children with newly diagnosed type 1 diabetes: long term follow-up.
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Superior Glycemic Control With a Glucose-Responsive Insulin Analog: Hepatic and Nonhepatic Impacts
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Couri CEB, Oliveira MCB, Stracieri ABPL, Moraes DA, Pieroni F, Barros GMN, Madeira MIA, Malmegrim KCR, Foss-Freitas MC, Simões BP, (2009b). C-Peptide Levels and Insulin Independence Following Autologous Nonmyeloablative Hematopoietic Stem Cell Transplantation in Newly Diagnosed Type 1 Diabetes Mellitus. Jama 301, 1573– 1579. 19366777

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Authors: Warshauer, J. T., Bluestone, J. A., & Anderson, M. S.
Affiliations: University of California, San Francisco (US)
Corresponding author: Anderson, Mark S.
ORCID: Warshauer, Jeremy T.
Bluestone, Jeffrey A.
Anderson, Mark S.
Venue: Cell Metabolism
Publisher: Elsevier BV
Published: 2020-01
Volume: 31
Issue: 1
Pages: 46-61
ISSN: 1550-4131 (ISSN-L)
DOI: 10.1016/j.cmet.2019.11.017
PMC: PMC6986815
OpenAlex: W2994810741
Semantic Scholar: c630811516a3147404801bdcf1197637539ef881
Cited by: 259
References: 140
Citations by year: 2026: 27 · 2025: 42 · 2024: 50 · 2023: 50 · 2022: 40 · 2021: 36 · 2020: 14
FWCI: 2.98
Type: journal article
Language: en
Open access: bronze
doi.org
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
www.elsevier.com/legal/tdmrep-license (tdm)
www.elsevier.com/open-access/userlicense/1.0/ (vor, 372 d)
Locations: Cell Metabolism (publishedVersion)
PubMed (publishedVersion)
Europe PMC (PubMed Central) (acceptedVersion)
PubMed Central (acceptedVersion)
eScholarship (California Digital Library) (submittedVersion)
Funders: Juvenile Diabetes Research Foundation International
National Institute of Allergy and Infectious Diseases
Topics: Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Diabetes and associated disorders
Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
Health Sciences › Medicine › Surgery › Pancreatic function and diabetes
Keywords: type 1 diabetes, islet autoimmunity, beta cell regeneration, islet transplantation, immunotherapy, immune tolerance, disease prevention, insulin deficiency, glycemic control, beta-cell development, glucose metabolism
MeSH terms: Animals, Cell Line, Diabetes Mellitus, Type 1, Humans, Immune Tolerance, Immunotherapy

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