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http://dx.doi.org/10.3345/kjp.2018.06870

Understanding of type 1 diabetes mellitus: what we know and where we go  

Cheon, Chong Kun (Department of Pediatrics, Pusan National University School of Medicine)
Publication Information
Clinical and Experimental Pediatrics / v.61, no.10, 2018 , pp. 307-314 More about this Journal
Abstract
The incidence of type 1 diabetes mellitus (T1DM) in children and adolescents is increasing worldwide. Combined effects of genetic and environmental factors cause T1DM, which make it difficult to predict whether an individual will inherit the disease. Due to the level of self-care necessary in T1DM maintenance, it is crucial for pediatric settings to support achieving optimal glucose control, especially when adolescents are beginning to take more responsibility for their own health. Innovative insulin delivery systems, such as continuous subcutaneous insulin infusion (CSII), and noninvasive glucose monitoring systems, such as continuous glucose monitoring (CGM), allow patients with T1DM to achieve a normal and flexible lifestyle. However, there are still challenges in achieving optimal glucose control despite advanced technology in T1DM administration. In this article, disease prediction and current management of T1DM are reviewed with special emphasis on biomarkers of pancreatic ${\beta}-cell$ stress, CSII, glucose monitoring, and several other adjunctive therapies.
Keywords
Type 1 diabetes mellitus; Biomarkers; Glucose monitoring; Glucose control;
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1 Lee JH, Kim YM, Kwak MJ, Kim SY, Kim HJ, Cheon CK, et al. Incidence trends and associated factors of diabetes mellitus in Korean children and adolescents: a retrospective cohort study in Busan and Gyeongnam. Ann Pediatr Endocrinol Metab 2015;20:206-12.   DOI
2 Kim JH, Lee CG, Lee YA, Yang SW, Shin CH. Increasing incidence of type 1 diabetes among Korean children and adolescents: analysis of data from a nationwide registry in Korea. Pediatr Diabetes 2016;17:519-24.   DOI
3 Rojas J, Bermudez V, Palmar J, Martinez MS, Olivar LC, Nava M, et al. Pancreatic beta cell death: novel potential mechanisms in diabetes therapy. J Diabetes Res 2018;2018:9601801.
4 Grant SF, Hakonarson H, Schwartz S. Can the genetics of type 1 and type 2 diabetes shed light on the genetics of latent autoimmune diabetes in adults? Endocr Rev 2010;31:183-93.   DOI
5 Mehers KL, Gillespie KM. The genetic basis for type 1 diabetes. Br Med Bull 2008;88:115-29.   DOI
6 Steck AK, Rewers MJ. Genetics of type 1 diabetes. Clin Chem 2011;57:176-85.   DOI
7 Bakay M, Pandey R, Hakonarson H. Genes involved in type 1 diabetes: an update. Genes (Basel) 2013;4:499-521.   DOI
8 Lamb MM, Miller M, Seifert JA, Frederiksen B, Kroehl M, Rewers M, et al. The effect of childhood cow's milk intake and HLA-DR genotype on risk of islet autoimmunity and type 1 diabetes: the Diabetes Autoimmunity Study in the Young. Pediatr Diabetes 2015;16:31-8.   DOI
9 Ziegler AG, Schmid S, Huber D, Hummel M, Bonifacio E. Early infant feeding and risk of developing type 1 diabetes-associated autoantibodies. JAMA 2003;290:1721-8.   DOI
10 Ellis SL, Moser EG, Snell-Bergeon JK, Rodionova AS, Hazenfield RM, Garg SK. Effect of sitagliptin on glucose control in adult patients with Type 1 diabetes: a pilot, double-blind, randomized, crossover trial. Diabet Med 2011;28:1176-81.   DOI
11 Giampietro O, Giampietro C, Bartola LD, Masoni MC, Matteucci E. Sitagliptin as add-on therapy in insulin deficiency: biomarkers of therapeutic efficacy respond differently in type 1 and type 2 diabetes. Drug Des Devel Ther 2013;7:99-104.
12 Guo H, Fang C, Huang Y, Pei Y, Chen L, Hu J. The efficacy and safety of DPP4 inhibitors in patients with type 1 diabetes: a systematic review and meta-analysis. Diabetes Res Clin Pract 2016;121:184-91.   DOI
13 Sonne DP, Hemmingsen B. Comment on American Diabetes Association. Standards of medical care in diabetes-2017. Diabetes Care 2017;40(Suppl. 1):S1-S135. Diabetes Care 2017;40:e92-3.   DOI
14 Garber AJ, Abrahamson MJ, Barzilay JI, Blonde L, Bloomgarden ZT, Bush MA, et al. Consensus statement by the American Association of Clinical Endocrinologists and American College of Endocrinology on the comprehensive type 2 diabetes management algorithm - 2017 executive summary. Endocr Pract 2017;23:207-38.   DOI
15 Henry RR, Rosenstock J, Edelman S, Mudaliar S, Chalamandaris AG, Kasichayanula S, et al. Exploring the potential of the SGLT2 inhibitor dapagliflozin in type 1 diabetes: a randomized, double-blind, placebocontrolled pilot study. Diabetes Care 2015;38:412-9.   DOI
16 Henry RR, Thakkar P, Tong C, Polidori D, Alba M. Efficacy and safety of canagliflozin, a sodium-glucose cotransporter 2 inhibitor, as addon to insulin in patients with type 1 diabetes. Diabetes Care 2015;38:2258-65.   DOI
17 Wahlberg J, Vaarala O, Ludvigsson J; ABIS-study group. Dietary risk factors for the emergence of type 1 diabetes-related autoantibodies in 21/2 year-old Swedish children. Br J Nutr 2006;95:603-8.   DOI
18 Frederiksen B, Kroehl M, Lamb MM, Seifert J, Barriga K, Eisenbarth GS, et al. Infant exposures and development of type 1 diabetes mellitus: The Diabetes Autoimmunity Study in the Young (DAISY). JAMA Pediatr 2013;167:808-15.   DOI
19 Knip M, Virtanen SM, Seppa K, Ilonen J, Savilahti E, Vaarala O, et al. Dietary intervention in infancy and later signs of beta-cell autoimmunity. N Engl J Med 2010;363:1900-8.   DOI
20 Knip M, Akerblom HK, Becker D, Dosch HM, Dupre J, Fraser W, et al. Hydrolyzed infant formula and early ${\beta}$-cell autoimmunity: a randomized clinical trial. JAMA 2014;311:2279-87.   DOI
21 Virtanen SM, Nevalainen J, Kronberg-Kippila C, Ahonen S, Tapanainen H, Uusitalo L, et al. Food consumption and advanced ${\beta}$ cell autoimmunity in young children with HLA-conferred susceptibility to type 1 diabetes: a nested case-control design. Am J Clin Nutr 2012;95:471-8.   DOI
22 Verge CF, Howard NJ, Irwig L, Simpson JM, Mackerras D, Silink M. Environmental factors in childhood IDDM. A population-based, casecontrol study. Diabetes Care 1994;17:1381-9.   DOI
23 Virtanen SM, Laara E, Hypponen E, Reijonen H, Rasanen L, Aro A, et al. Cow's milk consumption, HLA-DQB1 genotype, and type 1 diabetes: a nested case-control study of siblings of children with diabetes. Childhood diabetes in Finland study group. Diabetes 2000;49:912-7.   DOI
24 Betts P, Mulligan J, Ward P, Smith B, Wilkin T. Increasing body weight predicts the earlier onset of insulin-dependant diabetes in childhood: testing the 'accelerator hypothesis' (2). Diabet Med 2005;22:144-51.   DOI
25 Sorensen IM, Joner G, Jenum PA, Eskild A, Torjesen PA, Stene LC. Maternal serum levels of 25-hydroxy-vitamin D during pregnancy and risk of type 1 diabetes in the offspring. Diabetes 2012;61:175-8.   DOI
26 Rewers M, Ludvigsson J. Environmental risk factors for type 1 diabetes. Lancet 2016;387:2340-8.   DOI
27 Cheon CK, Nam HK, Lee KH, Kim SY, Song JS, Kim C. Vitamin D receptor gene polymorphisms and type 1 diabetes mellitus in a Korean population. Pediatr Int 2015;57:870-4.   DOI
28 Qin WH, Wang HX, Qiu JL, Huang XB, Huang Y, Wu NR, et al. A meta-analysis of association of vitamin D receptor BsmI gene polymorphism with the risk of type 1 diabetes mellitus. J Recept Signal Transduct Res 2014;34:372-7.   DOI
29 Miettinen ME, Reinert L, Kinnunen L, Harjutsalo V, Koskela P, Surcel HM, et al. Serum 25-hydroxyvitamin D level during early pregnancy and type 1 diabetes risk in the offspring. Diabetologia 2012;55:1291-4.   DOI
30 Zipitis CS, Akobeng AK. Vitamin D supplementation in early childhood and risk of type 1 diabetes: a systematic review and metaanalysis. Arch Dis Child 2008;93:512-7.   DOI
31 Simpson M, Brady H, Yin X, Seifert J, Barriga K, Hoffman M, et al. No association of vitamin D intake or 25-hydroxyvitamin D levels in childhood with risk of islet autoimmunity and type 1 diabetes: the Diabetes Autoimmunity Study in the Young (DAISY). Diabetologia 2011;54:2779-88.   DOI
32 Holmberg H, Wahlberg J, Vaarala O, Ludvigsson J; ABIS Study Group. Short duration of breast-feeding as a risk-factor for beta-cell autoantibodies in 5-year-old children from the general population. Br J Nutr 2007;97:111-6.   DOI
33 Kostic AD, Gevers D, Siljander H, Vatanen T, Hyotylainen T, Hamalainen AM, et al. The dynamics of the human infant gut microbiome in development and in progression toward type 1 diabetes. Cell Host Microbe 2015;17:260-73.   DOI
34 Virtanen SM, Niinisto S, Nevalainen J, Salminen I, Takkinen HM, Kaaria S, et al. Serum fatty acids and risk of advanced beta-cell autoimmunity: a nested case-control study among children with HLA-conferred susceptibility to type I diabetes. Eur J Clin Nutr 2010;64:792-9.   DOI
35 Wen L, Ley RE, Volchkov PY, Stranges PB, Avanesyan L, Stonebraker AC, et al. Innate immunity and intestinal microbiota in the development of Type 1 diabetes. Nature 2008;455:1109-13.   DOI
36 Maslowski KM, Mackay CR. Diet, gut microbiota and immune responses. Nat Immunol 2011;12:5-9.
37 Arpaia N, Campbell C, Fan X, Dikiy S, van der Veeken J, deRoos P, et al. Metabolites produced by commensal bacteria promote peripheral regulatory T-cell generation. Nature 2013;504:451-5.   DOI
38 Brown CT, Davis-Richardson AG, Giongo A, Gano KA, Crabb DB, Mukherjee N, et al. Gut microbiome metagenomics analysis suggests a functional model for the development of autoimmunity for type 1 diabetes. PLoS One 2011;6:e25792.   DOI
39 Richardson SJ, Willcox A, Bone AJ, Foulis AK, Morgan NG. The prevalence of enteroviral capsid protein vp1 immunostaining in pancreatic islets in human type 1 diabetes. Diabetologia 2009;52:1143-51.   DOI
40 Krogvold L, Edwin B, Buanes T, Frisk G, Skog O, Anagandula M, et al. Detection of a low-grade enteroviral infection in the islets of langerhans of living patients newly diagnosed with type 1 diabetes. Diabetes 2015;64:1682-7.   DOI
41 Sane F, Caloone D, Gmyr V, Engelmann I, Belaich S, Kerr-Conte J, et al. Coxsackievirus B4 can infect human pancreas ductal cells and persist in ductal-like cell cultures which results in inhibition of Pdx1 expression and disturbed formation of islet-like cell aggregates. Cell Mol Life Sci 2013;70:4169-80.   DOI
42 Sims EK, Chaudhry Z, Watkins R, Syed F, Blum J, Ouyang F, et al. Elevations in the fasting serum proinsulin-to-C-peptide ratio precede the onset of type 1 diabetes. Diabetes Care 2016;39:1519-26.   DOI
43 Mirmira RG, Sims EK, Syed F, Evans-Molina C. Biomarkers of ${\beta}$-Cell stress and death in type 1 diabetes. Curr Diab Rep 2016;16:95.   DOI
44 Butler AE, Cao-Minh L, Galasso R, Rizza RA, Corradin A, Cobelli C, et al. Adaptive changes in pancreatic beta cell fractional area and beta cell turnover in human pregnancy. Diabetologia 2010;53:2167-76.   DOI
45 Truyen I, De Pauw P, Jorgensen PN, Van Schravendijk C, Ubani O, Decochez K, et al. Proinsulin levels and the proinsulin:c-peptide ratio complement autoantibody measurement for predicting type 1 diabetes. Diabetologia 2005;48:2322-9.   DOI
46 Nielsen LB, Wang C, Sorensen K, Bang-Berthelsen CH, Hansen L, Andersen ML, et al. Circulating levels of microRNA from children with newly diagnosed type 1 diabetes and healthy controls: evidence that miR-25 associates to residual beta-cell function and glycaemic control during disease progression. Exp Diabetes Res 2012;2012:896362.
47 Kanak MA, Takita M, Shahbazov R, Lawrence MC, Chung WY, Dennison AR, et al. Evaluation of microRNA375 as a novel biomarker for graft damage in clinical islet transplantation. Transplantation 2015;99:1568-73.   DOI
48 Husseiny MI, Kaye A, Zebadua E, Kandeel F, Ferreri K. Tissue-specific methylation of human insulin gene and PCR assay for monitoring beta cell death. PLoS One 2014;9:e94591.   DOI
49 Yang BT, Dayeh TA, Kirkpatrick CL, Taneera J, Kumar R, Groop L, et al. Insulin promoter DNA methylation correlates negatively with insulin gene expression and positively with HbA(1c) levels in human pancreatic islets. Diabetologia 2011;54:360-7.   DOI
50 Rodbard D. Continuous glucose monitoring: a review of recent studies demonstrating improved glycemic outcomes. Diabetes Technol Ther 2017;19(S3):S25-37.   DOI
51 Beck RW, Riddlesworth T, Ruedy K, Ahmann A, Bergenstal R, Haller S, et al. Effect of continuous glucose monitoring on glycemic control in adults with type 1 diabetes using insulin injections: the DIAMOND randomized clinical trial. JAMA 2017;317:371-8.   DOI
52 Bolinder J, Antuna R, Geelhoed-Duijvestijn P, Kroger J, Weitgasser R. Novel glucose-sensing technology and hypoglycaemia in type 1 diabetes: a multicentre, non-masked, randomised controlled trial. Lancet 2016;388:2254-63.   DOI
53 van Beers CA, DeVries JH, Kleijer SJ, Smits MM, Geelhoed-Duijvestijn PH, Kramer MH, et al. Continuous glucose monitoring for patients with type 1 diabetes and impaired awareness of hypoglycaemia (in control): a randomised, open-label, crossover trial. Lancet Diabetes Endocrinol 2016;4:893-902.   DOI
54 Edelman SV. Regulation catches up to reality. J Diabetes Sci Technol 2017;11:160-4.   DOI
55 Pettus J, Edelman SV. Recommendations for using real-time continuous glucose monitoring (rtCGM) data for insulin adjustments in type 1 diabetes. J Diabetes Sci Technol 2017;11:138-47.   DOI
56 Lind M, Polonsky W, Hirsch IB, Heise T, Bolinder J, Dahlqvist S, et al. Continuous glucose monitoring vs conventional therapy for glycemic control in adults with type 1 diabetes treated with multiple daily insulin injections: the GOLD randomized clinical trial. JAMA 2017;317:379-87.   DOI
57 Preiser JC, Chase JG, Hovorka R, Joseph JI, Krinsley JS, De Block C, et al. Glucose control in the ICU: a continuing story. J Diabetes Sci Technol 2016;10:1372-81.   DOI
58 Kaiserman K, Rodriguez H, Stephenson A, Wolka L, Fahrbach JL. Continuous subcutaneous infusion of insulin lispro in children and adolescents with type 1 diabetes mellitus. Endocr Pract 2012;18:418-24.   DOI
59 Wallia A, Umpierrez GE, Nasraway SA, Klonoff DC; PRIDE Investigators. Round table discussion on inpatient use of continuous glucose monitoring at the international hospital diabetes meeting. J Diabetes Sci Technol 2016;10:1174-81.   DOI
60 Thabit H, Hartnell S, Allen JM, Lake A, Wilinska ME, Ruan Y, et al. Closed-loop insulin delivery in inpatients with type 2 diabetes: a randomised, parallel-group trial. Lancet Diabetes Endocrinol 2017;5:117-24.   DOI
61 Golden SH, Sapir T. Methods for insulin delivery and glucose monitoring in diabetes: summary of a comparative effectiveness review. J Manag Care Pharm 2012;18(6 Suppl):S1-17.
62 Ruiz-de-Adana MS, Dominguez-Lopez ME, Gonzalez-Molero I, Machado A, Martin V, Cardona I, et al. Comparison between a multiple daily insulin injection regimen (basal once-daily glargine plus mealtime lispro) and continuous subcutaneous insulin infusion (lispro) using continuous glucose monitoring in metabolically optimized type 1 diabetes patients: a randomized open-labelled parallel study. Med Clin (Barc) 2016;146:239-46.   DOI
63 Harris K, Boland C, Meade L, Battise D. Adjunctive therapy for glucose control in patients with type 1 diabetes. Diabetes Metab Syndr Obes 2018;11:159-73.   DOI
64 Hamilton J, Cummings E, Zdravkovic V, Finegood D, Daneman D. Metformin as an adjunct therapy in adolescents with type 1 diabetes and insulin resistance: a randomized controlled trial. Diabetes Care 2003;26:138-43.   DOI
65 Shaw JE, Sicree RA, Zimmet PZ. Global estimates of the prevalence of diabetes for 2010 and 2030. Diabetes Res Clin Pract 2010;87:4-14.   DOI
66 Standards of Medical Care in Diabetes-2017: Summary of Revisions. Diabetes Care 2017;40(Suppl 1):S4-5.   DOI
67 Diabetes Control and Complications Trial (DCCT)/Epidemiology of Diabetes Interventions and Complications (EDIC) Study Research Group. Intensive diabetes treatment and cardiovascular outcomes in type 1 diabetes: the DCCT/EDIC study 30-year follow-up. Diabetes Care 2016;39:686-93.   DOI
68 Punnose J, Agarwal MM, El Khadir A, Devadas K, Mugamer IT. Childhood and adolescent diabetes mellitus in Arabs residing in the United Arab Emirates. Diabetes Res Clin Pract 2002;55:29-33.   DOI
69 Karvonen M, Viik-Kajander M, Moltchanova E, Libman I, LaPorte R, Tuomilehto J. Incidence of childhood type 1 diabetes worldwide. Diabetes Mondiale (DiaMond) Project Group. Diabetes Care 2000;23:1516-26.   DOI
70 Nadeau KJ, Chow K, Alam S, Lindquist K, Campbell S, McFann K, et al. Effects of low dose metformin in adolescents with type I diabetes mellitus: a randomized, double-blinded placebo-controlled study. Pediatr Diabetes 2015;16:196-203.   DOI
71 Libman IM, Miller KM, DiMeglio LA, Bethin KE, Katz ML, Shah A, et al. Effect of metformin added to insulin on glycemic control among overweight/obese adolescents with type 1 diabetes: a randomized clinical trial. JAMA 2015;314:2241-50.   DOI
72 Nwosu BU, Maranda L, Cullen K, Greenman L, Fleshman J, McShea N, et al. A randomized, double-blind, placebo-controlled trial of adjunctive metformin therapy in overweight/obese youth with type 1 diabetes. PLoS One 2015;10:e0137525.   DOI
73 Farngren J, Persson M, Schweizer A, Foley JE, Ahren B. Vildagliptin reduces glucagon during hyperglycemia and sustains glucagon counterregulation during hypoglycemia in type 1 diabetes. J Clin Endocrinol Metab 2012;97:3799-806.   DOI
74 Garg SK, Moser EG, Bode BW, Klaff LJ, Hiatt WR, Beatson C, et al. Effect of sitagliptin on post-prandial glucagon and GLP-1 levels in patients with type 1 diabetes: investigator-initiated, double-blind, randomized, placebo-controlled trial. Endocr Pract 2013;19:19-28.
75 Schopman JE, Hoekstra JB, Frier BM, Ackermans MT, de Sonnaville JJ, Stades AM, et al. Effects of sitagliptin on counter-regulatory and incretin hormones during acute hypoglycaemia in patients with type 1 diabetes: a randomized double-blind placebo-controlled crossover study. Diabetes Obes Metab 2015;17:546-53.   DOI
76 Sarnblad S, Kroon M, Aman J. Metformin as additional therapy in adolescents with poorly controlled type 1 diabetes: randomised placebo-controlled trial with aspects on insulin sensitivity. Eur J Endocrinol 2003;149:323-9.