From survival to freedom: redefining success in type 1 diabetes - PubMed

5 hours ago

Type 1 diabetes has evolved from a fatal condition to a chronic disease due to advancements like intensive insulin therapy, continuous glucose monitoring, and hybrid closed-loop systems.
Despite achieving near-normoglycaemia, residual risks like excess mortality and cardiovascular issues persist, linked to long-term biological effects of earlier dysglycaemia.
Morbidity in type 1 diabetes now includes cognitive decline, depression, infections, and cancer, alongside the high daily burden of disease management.
Future therapeutic goals focus on physiological resilience, aiming to restore endogenous regulation, reduce glycaemic variability, and minimize inflammatory stress.
β-cell replacement therapies should be evaluated based on durability, safety, C-peptide preservation, time in range, and patient-reported outcomes, not just HbA1c levels.
Success in type 1 diabetes treatment should be redefined to include not only survival but also improved physiological control with minimal toxicity and reduced cognitive burden.
The article advocates for a shift in focus from glycaemic metrics alone to restoring endogenous regulation and physiological resilience, emphasizing metabolic stability and reduced therapeutic burden.

Hasty Briefsbeta