Diabetes Mellitus, Type 1
BASICS
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)[ ]
- 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).
Incidence
- In the United States, incidence is 23.6/100,000 in non-Hispanic white children and adolescents.
Prevalence
- Global prevalence is 5.9 per 10,000 people (2)[ ].
ETIOLOGY AND PATHOPHYSIOLOGY
There are two main categories of T1DM (3)[ ].
- Immune-mediated diabetes (90–95% of cases)
- Idiopathic diabetes: classic T1DM presentation with no evidence of autoimmunity
Genetics
- T1DM has strong HLA associations, with linkage to the DQB1 and DRB1 haplotypes (3)[ ].
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)[ ].
COMMONLY ASSOCIATED CONDITIONS
- Other autoimmune diseases (thyroid, celiac disease, primary adrenal insufficiency, atrophic gastritis)
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Citation
Domino, Frank J., et al., editors. "Diabetes Mellitus, Type 1." 5-Minute Clinical Consult, 34th ed., Wolters Kluwer, 2026. Medicine Central, im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/116180/all/Diabetes_Mellitus_Type_1.
Diabetes Mellitus, Type 1. In: Domino FJF, Baldor RAR, Golding JJ, et al, eds. 5-Minute Clinical Consult. Wolters Kluwer; 2026. https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/116180/all/Diabetes_Mellitus_Type_1. Accessed July 16, 2025.
Diabetes Mellitus, Type 1. (2026). In Domino, F. J., Baldor, R. A., Golding, J., & Stephens, M. B. (Eds.), 5-Minute Clinical Consult (34th ed.). Wolters Kluwer. https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/116180/all/Diabetes_Mellitus_Type_1
Diabetes Mellitus, Type 1 [Internet]. In: Domino FJF, Baldor RAR, Golding JJ, Stephens MBM, editors. 5-Minute Clinical Consult. Wolters Kluwer; 2026. [cited 2025 July 16]. Available from: https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/116180/all/Diabetes_Mellitus_Type_1.
* Article titles in AMA citation format should be in sentence-case
TY - ELEC
T1 - Diabetes Mellitus, Type 1
ID - 116180
ED - Domino,Frank J,
ED - Baldor,Robert A,
ED - Golding,Jeremy,
ED - Stephens,Mark B,
BT - 5-Minute Clinical Consult, Updating
UR - https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/116180/all/Diabetes_Mellitus_Type_1
PB - Wolters Kluwer
ET - 34
DB - Medicine Central
DP - Unbound Medicine
ER -