Global burden of type 1 diabetes in adults aged 65 years and older, 1990-2019: population based study

BMJ, Journal Year: 2024, Volume and Issue: unknown, P. e078432 - e078432

Published: June 12, 2024

Abstract Objectives To estimate the burden, trends, and inequalities of type 1 diabetes mellitus (T1DM) among older adults at global, regional, national level from 1990 to 2019. Design Population based study. Adults aged ≥65 years 21 regions 204 countries territories (Global Burden Disease Risk Factors Study 2019) Main outcome measures Primary outcomes were T1DM related age standardised prevalence, mortality, disability adjusted life (DALYs), average annual percentage change. Results The global prevalence increased 400 (95% uncertainty interval (UI) 332 476) per 100 000 population in 514 (417 624) 2019, with an trend 0.86% confidence (CI) 0.79% 0.93%); while mortality decreased 4.74 UI 3.44 5.9) 3.54 (2.91 4.59) population, −1.00% CI −1.09% −0.91%), DALYs 113 89 137) 103 (85 127) −0.33% −0.41% −0.25%). most significant decrease was observed those <79 years: 65-69 (−0.44% year −0.53% −0.34%)), 70-74 (−0.34% (−0.41% −0.27%)), 75-79 (−0.42% (−0.58% −0.26%)). Mortality fell 13 times faster a high sociodemographic index versus low-middle (−2.17% −2.31% −2.02%) v −0.16% (−0.45% 0.12%)). While highest remained income North America, Australasia, western Europe, DALY rates found southern sub-Saharan Africa, Oceania, Caribbean. A fasting plasma glucose risk factor for during 1990-2019. Conclusions expectancy people has since 1990s along considerable associated DALYs. lower women years, living index, years. Management remains major challenge T1DM, targeted clinical guidelines are needed.

Language: Английский

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Type 1 diabetes: A new vision of the disease based on endotypes

Diabetes/Metabolism Research and Reviews, Journal Year: 2024, Volume and Issue: 40(2)

Published: Feb. 1, 2024

Abstract Diagnosis and management of type 1 diabetes (T1D) have remained largely unchanged for the last several years. The disease remains primarily focused on its phenotypical presentation less endotypes, namely specific biological mechanisms behind development disease. Furthermore, treatment T1D is essentially universal indiscriminate—with patients administering insulin at varying dosages frequencies to maintain adequate glycaemic control. However, it now well understood that a heterogeneous with many different (i.e. endotypes) complex pathophysiology. A range factors, including age onset, immune system regulation, rate β‐cell destruction, autoantibodies, body weight, genetics exposome are recognised play role in condition. Patients can be classified into distinct diabetic subtypes based these which used categorise endotypes. classification endotypes allows greater understanding natural progression disease, giving rise more accurate patient‐centred therapies follow‐up monitoring, specifically other autoimmune diseases. This review proposes 6 unique current literature. recognition could then direct therapeutic modalities patients' individual

Language: Английский

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The epidemiology of type 1 diabetes mellitus in older adults

Nature Reviews Endocrinology, Journal Year: 2024, Volume and Issue: unknown

Published: Oct. 24, 2024

Language: Английский

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Trends in the incidence of young-adult-onset diabetes by diabetes type: a multi-national population-based study from an international diabetes consortium

The Lancet Diabetes & Endocrinology, Journal Year: 2024, Volume and Issue: 12(12), P. 915 - 923

Published: Nov. 11, 2024

Language: Английский

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IFN-α neutralizing antibodies distinguish LADA from early-onset type 1 diabetes

The Journal of Clinical Endocrinology & Metabolism, Journal Year: 2025, Volume and Issue: unknown

Published: Jan. 6, 2025

Autoantibodies against IFN-α (AAb-IFN-α) might be associated with the less aggressive autoimmunity in latent autoimmune diabetes adults (LADA) compared to early-onset type 1 (T1D).

Language: Английский

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Technological functionality and system architecture of mobile health interventions for diabetes management: a systematic review and meta-analysis of randomized controlled trials

Frontiers in Public Health, Journal Year: 2025, Volume and Issue: 13

Published: Feb. 20, 2025

Introduction Despite advancements in digital health, systematic evaluations of mobile applications (Apps) for diabetes management are limited. Methods Researchers conducted searches on PUBMED, EMBASE, COCHRANE, SCOPUS, and WEB OF SCIENCE from inception to August 2024. The researchers included randomized controlled trials (RCTs) that investigated the effectiveness app-based interventions health among diabetic patients. Reviewers were paired independently screening studies, data extraction, evaluation study quality. primary outcome interest was modification hemoglobin A1c (HbA1c). utilized a random effects model calculate weighted mean differences (WMDs) 95% confidence intervals (CIs) used I 2 statistic assess heterogeneity. Publication bias outcomes underwent assessment. Studies Appraised quality using Cochrane Risk Bias Results 41 studies 3911 initially identified articles met selection criteria. results showed Apps’ intervention significantly improved glycemic control patients, with reduction HbA1c levels 0.49% (95%CI: –0.65 –0.32%) compared standard care. analysis also revealed Apps enhanced patient self-management behaviors. Subgroup analyses failed resolve heterogeneity, but consistently observed levels. assessment indicated most performed well completeness selective reporting. Discussion This meta-analysis confirms practical technological functionalities system architectures beneficial managing diabetes. These reduced Although some exhibited moderate risk bias, overall evidence supports these as valuable tools Future research should standardize application features, refine architectures, address issues enhance. Systematic Review Registration PROSPERO (CRD42023441365).

Language: Английский

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Envisioning Tools to Help Classify Type 1 Diabetes and Type 2 Diabetes in New-Onset Adult Diabetes

Journal of Diabetes Science and Technology, Journal Year: 2025, Volume and Issue: unknown

Published: March 28, 2025

A tool is needed to distinguish type 1 diabetes (T1D) and 2 (T2D) in adults with new-onset because correct classification for diagnoses treatments. Current methods are usually applied biomarkers using binary or quantitative a cut point may not be adequately nuanced. Combinations of clinical features necessarily specific classifying always indicate single diagnosis. probabilistic decision tree multiple branches per node avoid misdiagnosis actual T1D as T2D, T2D monogenic T1D, misclassified patients future population health studies which will lead incorrect conclusions suboptimal patient outcomes.

Language: Английский

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Insights on metabolic connections and interplay between cancer and diabetes: role of multi-target drugs

Deleted Journal, Journal Year: 2025, Volume and Issue: 2(1)

Published: March 26, 2025

Language: Английский

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Type 1 diabetes presenting in adults: Trends, diagnostic challenges and unique features

Diabetes Obesity and Metabolism, Journal Year: 2025, Volume and Issue: unknown

Published: April 15, 2025

Abstract Type 1 diabetes (T1D) has been historically regarded as a childhood‐onset disease; however, recent epidemiological data indicate that adult‐onset T1D accounts for substantial proportion of cases worldwide. There is evidence associated with the classic triad elevated genetic risk, presence islet‐specific autoantibodies and progression to severe insulin deficiency. In this article, we review our understanding commonalities differences between childhood T1D, highlight significant knowledge gaps in diagnosis, incidence, trajectory treatment T1D. Compared children, adults presenting exhibit immunologic profiles metabolic outcomes, including type number present, associations total burden, rates C‐peptide decline, persistence long‐duration disease glycaemic control. addition, obesity syndrome are increasingly common adults, which not only blurs clinical distinction from 2 (T2D) but also likely contributes outcomes progression. Because T2D so prevalent adult population, misclassified at least one three cases, leading delays appropriate treatment. Current diagnostic tools, autoantibody testing measurement, underutilised or lack specificity distinguishing atypical T2D. Additionally, impact different responses disease‐modifying therapy children unclear. Addressing these requires expanded studies, diverse patient registries refined classification criteria improve early detection strategies. A deeper will be critical reduce burden misdiagnosis, lead earlier diagnosis optimise population‐based screening approaches under‐recognised population. Plain Language Summary an autoimmune causes nutritional complications due destruction insulin‐producing pancreatic β cells. was formerly known “juvenile diabetes” because it assumed most occurred childhood; show nearly half all diagnosed adulthood. Despite high prevalence there challenges correctly diagnosing adulthood, remain regarding trajectory, summarize current Particularly, age‐related profiles, complications. Finally, key need addressed misdiagnosis allow better

Language: Английский

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Small things matter: Lack of extra-islet beta cells in Type 1 diabetes

bioRxiv (Cold Spring Harbor Laboratory), Journal Year: 2025, Volume and Issue: unknown

Published: April 17, 2025

Summary Recent 3D analyses reported abundant, small beta-cell-rich endocrine objects (EOs) in the human pancreas. Here, we assessed morphological parameters of >262,000 EOs pancreas sections from 220 donors with or without type 1 diabetes (T1D), ranging age and disease duration. We observe many insulin (Ins)+/glucagon (Gluc)-EOs diabetes. Their relative contribution to total area is greatest early life (0-2y) but reduces thereafter. Strikingly, show virtual absence Ins+Gluc- individuals T1D, where only medium large retain beta cells. also report a lower EO density especially diagnosed life. These findings suggest that extra-islet cells are impacted development their loss characteristic feature. This new understanding has important implications for defining beta-cell mass, which may inform future screening treatment strategies T1D. Highlights The present extensive 2D studies confirm extend recent pancreata, demonstrating 50% much smaller than classical islets Langerhans consist predominantly (Ins+). Small insulin+ comprise largest proportion childhood persist throughout course There shift towards larger size increasing age, most pronounced changes occurring first few years Ins+ virtually absent diabetes, while persisting larger, suggesting selective destruction EOs. Development particularly at an associated fewer adulthood. implies lack be detrimental generation

Language: Английский

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