Type 1 diabetes mellitus (T1DM): A Review

Abstract

Type 1 diabetes mellitus (T1DM), also known as insulin-dependent diabetes, is a metabolic disease marked by increased blood glucose, hyperglycemia, following the destruction of insulin-supplying pancreatic β-cells within the islets of Langerhans. T1DM etiology is not fully resolved, however it is clear that a combination of genetic and environmental factors trigger T-cell mediated β-cell-targeted autoimmunity and contribute to disease progression. T1DM constitutes about 5%–10% of all cases of diabetes and is the most common form of diabetes among children and young adolescents. The global trend of increasing prevalence highlights the need for improving our understanding of T1DM. The majority of T1DM patients are diagnosed during the symptomatic stage of disease when 80% to 90% of β-cell mass has been destroyed, making intervention or reversal of disease extremely challenging. Hence, there is a growing need for prognostic biomarkers that would allow for early detection of disease before or during pre-symptomatic stages. Although lifelong exogenous insulin therapy can be effective in regulating glucose homeostasis to reduce the effect of hyperglycemia on organ and metabolic functions, there is no effective disease-modifying cure available for T1DM. Therefore, efforts for early prevention and intervention in disease progression are crucial to improving disease outcomes. This review examines T1DM on molecular, cellular, organismic, and population scales with special emphasis on diagnostic and prognostic markers.