Update in Type 1 Diabetes
Abstract
CONTEXT: Type 1 diabetes is a heterogeneous disorder characterized by severe beta-cell loss. The great majority of patients have type 1A or immune-mediated diabetes. SYNTHESIS: There has been recent progress in defining the genetics, pathogenesis, and natural history of the disease. In addition, there is a major effort to develop immunotherapies to prevent the disorder and to cure the disease with islet transplantation, and there is potential for dramatic improvement in care with introduction of continuous glucose monitoring devices. The discovery of "metabolic memory" underscores the importance of excellent metabolic control. With comprehensive care, major microvascular complications (e.g. blindness and renal failure) are preventable for most patients. CONCLUSION: The existence of multiple "competing" technologies to deal with this devastating disorder holds promise of improved outcomes.
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Type 1A (autoimmune) diabetes accounts for the 70-90% of patients with type 1 disease that have immunological, self-reactive autoantibodies.
“leading to proposed classifications of type 1A (autoimmune) diabetes,41 for the 70–90% of patients with type 1 disease that have immunological, self-reactive autoantibodies”
From Type 1 diabetes (2014) · cites this paper as [41]
The classification section identifies type 1A as immune-mediated diabetes and anti-islet autoantibodies as its best distinguishing markers. It says approximately 90% of newly diagnosed patients with type 1A diabetes have one or more measured autoantibodies; it does not say that 70–90% of all patients with type 1 diabetes have autoantibodies or belong to the type 1A category. (LLM, conf=0.88)
Experimental — accuracy not yet measuredNot all individuals with anti-β-cell autoimmunity progress to overt disease; less than 5% who express a single type 1 diabetes-associated autoantibody progress.
“Not all individuals with anti-β-cell autoimmunity progress to overt disease (less than 5% who express a single type 1 diabetes-associated autoantibody progress41), for reasons unknown.”
From Type 1 diabetes (2014) · cites this paper as [41]
The Prediction section (page unavailable) says that having at least two islet autoantibodies is highly predictive of progression, supporting the distinction between autoantibody expression and overt diabetes. It does not give a progression rate for people with a single autoantibody, so the claimed figure of less than 5% is unsupported. (LLM, conf=0.82)
Experimental — accuracy not yet measuredNot all patients with type 1 diabetes have immunological characteristics, leading to proposed classifications of type 1A (autoimmune) diabetes and type 1B (idiopathic) diabetes.
“However, not all patients with type 1 diabetes have these characteristics, leading to proposed classifications of type 1A (autoimmune) diabetes,41 for the 70–90% of patients with type 1 disease that have immunological, self-reactive autoantibodies, and type 1B (idiopathic) diabetes, representing the remainder whose specific pathogenesis remains unclear.42”
From Type 1 diabetes (2014) · cites this paper as [41]
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Cites
Neuropathy among the diabetes control and complications trial cohort 8 years after trial completion
Martin, C. L., Albers, J., Herman, W. H., Cleary, P., Waberski, B., Greene, D. A., Stevens, M. J., & Feldman, E. L. (2006) · Diabetes Care · doi:10.2337/diacare.29.02.06.dc05-1549 · Cited by 350 · see citing works
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Research works printed but not linked: 1
- Bisikirska B, Colgan J, Luban J, Bluestone JA, Herold KC 2005 TCR stim- 2406 J Clin Endocrinol Metab, July 2007, 92(7):2403-2407 Eisenbarth • Update: Type 1 Diabetes ulation with modified anti-CD3 mAb expands CD8 T cell population and induces CD8CD25 Tregs. J Clin Invest 115:2904 -2913
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Atkinson, M. A., Eisenbarth, G. S., & Michels, A. W. (2014) · The Lancet · doi:10.1016/s0140-6736(13)60591-7 · Cited by 2,713 · see citing works
Self-citationZhang, Z., Liew, C. W., Handy, D. E., Zhang, Y., Leopold, J. A., Hu, J., Guo, L., Kulkarni, R. N., Loscalzo, J., & Stanton, R. C. (2010) · The FASEB Journal · doi:10.1096/fj.09-136572 · Cited by 226 · see citing works
Sosenko, J. M., Palmer, J. P., Rafkin-Mervis, L., Krischer, J. P., Cuthbertson, D., Mahon, J., Greenbaum, C. J., Cowie, C. C., Skyler, J. S., & the Diabetes Prevention Trial–Type 1 Study Group (2009) · Diabetes Care · doi:10.2337/dc08-2140 · Cited by 76 · see citing works
Sosenko, J. M., Palmer, J. P., Rafkin, L. E., Krischer, J. P., Cuthbertson, D., Greenbaum, C. J., Eisenbarth, G., Skyler, J. S., & Diabetes Prevention Trial–Type 1 Study Group (2010) · Diabetes Care · doi:10.2337/dc09-1770 · Cited by 62 · see citing works
Self-citationWITHDRAWN: Reprint of: Classification of diabetes mellitus
Adler, A., Bennett, P., Chair, S. C., Gregg, E., Venkat Narayan, K. M., Schmidt, M. I., Sobngwi, E., Tajima, N., Tandon, N., Unwin, N., et al. (2021) · Diabetes Research and Clinical Practice · doi:10.1016/j.diabres.2021.108972 · Cited by 38 · see citing works
Retracted
- Authors
- Eisenbarth, G. S.
- Affiliations
- University of Colorado Health (US)
- Corresponding author
- Eisenbarth, George S.
- Venue
- The Journal of Clinical Endocrinology & Metabolism
- Publisher
- The Endocrine Society
- Published
- 2007-07-01
- Volume
- 92
- Issue
- 7
- Pages
- 2403-2407
- ISSN
- 0021-972X (ISSN-L)
- 1945-7197
- OpenAlex
- W2006845692
- Cited by
- 144
- References
- 1
- Citations by year
- 2026: 2 · 2025: 2 · 2024: 2 · 2023: 3 · 2022: 3 · 2021: 3 · 2020: 3 · 2019: 7 · 2018: 6 · 2017: 5 · 2016: 5 · 2015: 8 · 2014: 9 · 2013: 9 · 2012: 11
- FWCI
- 1.82
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The Journal of Clinical Endocrinology & Metabolism (publishedVersion)
- PubMed (publishedVersion)
- 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, beta cell destruction, immune-mediated diabetes, type 1A diabetes, pathogenesis, natural history (disease), immunotherapy, islet transplantation, continuous glucose monitoring, metabolic memory, glycemic control, microvascular complications, diabetic blindness, diabetic nephropathy
- MeSH terms
- Diabetes Mellitus, Type 1, Humans, Diabetes Complications
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