Type 1 diabetes (T1D) is a chronic autoimmune disease marked by the destruction of pancreatic β-cells, resulting in insulin deficiency. The discovery of insulin a century ago revolutionized the management of T1D and extended the life expectancy of those affected. However, individuals with T1D remain at high risk of severe complications, highlighting the need for new interventions to improve outcomes for the growing number of diagnosed patients.
Insulin is the primary treatment for T1D. The development of new insulin analogs, including basal and short-acting insulins, has enhanced treatment management and glycemic control. Digital health management also plays a crucial role in T1D care. Innovations such as closed-loop systems, which integrate a continuous glucose monitor, an insulin pump, and a control algorithm to regulate insulin delivery based on real-time glucose measurements, along with decision support systems, have significantly improved diabetes management and quality of life for patients. Despite these technological advances, managing T1D remains burdensome, and many patients fail to achieve treatment targets, putting them at risk for severe complications. Additionally, a significant number of T1D patients, including children, are affected by obesity, which exacerbates insulin resistance and glycemic control issues. Consequently, interventions targeting weight loss are needed to improve insulin sensitivity and overall glycemic control.
Research indicates that patients with T1D who maintain better β-cell function achieve better glycemic control and experience fewer long-term complications and hypoglycemic episodes. Therefore, disease-modifying therapies aim to target autoimmune mechanisms and prevent β-cell destruction. Immunotherapy shows promise as a disease-modifying treatment in T1D, with various agents targeting the key autoreactive immune pathways involved in the disease. Therapies that interfere with T-cell activation are particularly promising. Regenerative therapies, such as islet cell and stem cell transplantation, are also advancing.
Currently, preventing T1D is not possible, but ongoing research aims to screen and identify potential risk factors and develop preventive strategies. This special issue focuses on the clinical applications of early T1D screening, novel disease-modifying therapeutic interventions for early-stage T1D that may prevent or reverse symptomatic T1D, and advancements in diabetes care, including new insulins and devices.
We hope that the readers of this special issue dealing with new curative treatment strategies and new therapies for T1D will find it stimulating and that they will get a broad view of recent findings in this field. We wish to thank the authors for their great contributions to this issue by sharing also their knowledge and expertise.
Conflict of Interest Statement
The authors have no conflicts of interest to declare. Profs. Shlomit Shalitin and Moshe Phillip were members of the journal’s Editorial Board at the time of submission.
Funding Sources
This study was not supported by any sponsor or funder.
Author Contributions
Shlomit Shalitin: conceptualization and writing – original draft. Moshe Phillip: review and editing.
Funding Statement
This study was not supported by any sponsor or funder.
