Diabetes Mellitus, Type 1

DESCRIPTION

• Type 1 diabetes mellitus (T1DM) is a chronic disease caused by insulin deficiency following autoimmune β-cell destruction.
• Three stages have been described:
  • 1: positive autoantibodies with normoglycemia
  • 2: positive autoantibodies with glucose intolerance
  • 3: positive autoantibodies with overt diabetes (autoantibodies may disappear over time) (1)[C]
• The velocity of presentation depends on the rate of β-cell destruction.
• System(s) affected: endocrine, cardiovascular, nervous, renal, ocular

EPIDEMIOLOGY

• T1DM accounts for 5–10% of all cases of diabetes.
• T1DM can occur at any age (incidence peaks in puberty and early adulthood).

ETIOLOGY AND PATHOPHYSIOLOGY

There are two main categories of T1DM (3)[C].

• Immune-mediated diabetes (90–95% of cases)
• Idiopathic diabetes: classic T1DM presentation with no evidence of autoimmunity

RISK FACTORS

• Increased susceptibility to T1DM is inheritable

GENERAL PREVENTION

• Teplizumab is approved in individuals aged ≥8 years with stage 2 T1DM, to delay the progression to stage 3 (3)[C].

COMMONLY ASSOCIATED CONDITIONS

• Other autoimmune diseases (thyroid, celiac disease, primary adrenal insufficiency, atrophic gastritis)