What is new in type 1 diabetes?

Published on February 28, 2023   37 min

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Other Talks in the Series: Periodic Reports: Advances in Clinical Interventions and Research Platforms

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What Is New in Type 1 Diabetes? My name is Åke Lernmark. I am at Lund University, Clinical Research Center in Malmö, Sweden.
My disclosures are that I am a member of the Scientific Advisory Board of Diamyd Medical in Stockholm, Sweden, and also the European Advisory Board of ProventionBio, in the United States.
This is the map of incidence rates of type 1 diabetes in the world. The color coding is such that countries with a high incidence rate are marked black. As you can see, the highest incidence rates of this disease are in the Scandinavian countries, Saudi Arabia, Algeria, and North America. And the disease is increasing by three to five percent per year. It is noted that in all these countries throughout the world, only 10 percent have a first-degree relative with type 1 diabetes.
The cause and effect are important to understand in the research of type 1 diabetes. There are two events that need to be kept in mind when attempting to understand the development of type 1 diabetes. One event is the trigger and the other event is the effect of the trigger. The first event is referred to as etiology, which is defined as the cause or origin of disease. It can be divided into two parts. One is the genetic etiology, illustrated by the family to your right. As you can see, there are four children but only one of the children will inherit from the parents the risk of developing type 1 diabetes. You inherit the risk, not the disease. The other factor is environmental factors, and I'm illustrating that with three different types of viruses, but it could also be other environmental factors yet to be determined. Pathogenesis is the natural progression of the disease that will take place once the trigger has initiated the autoimmunity against the pancreatic beta cells. The diagnosis of type 1 diabetes is a late endpoint after years of symptom-free disease, which is eradicating the pancreatic islet beta cells. The result of the pathogenesis leading to the diagnosis is that the patient is going to require daily insulin therapy because most of the beta cell and the beta cell function is lost.