Description

• Type 1 diabetes mellitus (T1D) 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.
• Systems affected: endocrine, cardiovascular, nervous, renal, ocular

Epidemiology

• T1D accounts for 5–10% of all cases of diabetes.
• T1D can occur at any age (incidence peaks in puberty and early adulthood).

Etiology and Pathophysiology

There are two main categories of T1D (3)[C].

• Immune-mediated (90–95% of cases)
• Idiopathic: classic T1D presentation with no evidence of autoimmunity

Risk Factors

Increased susceptibility to T1D is inheritable.

General Prevention

Teplizumab is approved in individuals aged ≥8 years with stage 2 T1D, to delay the progression to stage 3 (3)[C].

Commonly Associated Conditions

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