Pathology, Complications, and Prognosis of Type 1 Diabetes (T1D)

A special issue of Biomedicines (ISSN 2227-9059). This special issue belongs to the section "Endocrinology and Metabolism Research".

Deadline for manuscript submissions: closed (31 March 2026) | Viewed by 1703

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Guest Editor
School of Pharmacy, University of Texas, El Paso, TX 79968, USA
Interests: pharmacoepidemiology; type 1 diabetes; cardiovascular outcomes; health services research; medication adherence; pharmacoeconomics
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Special Issue Information

Dear Colleagues,

Type 1 diabetes (T1D) is a chronic autoimmune disease that results in lifelong dependence on insulin therapy and predisposes individuals to a wide range of acute and chronic complications. Despite major advances in glucose monitoring, insulin delivery systems, and adjunctive therapies, the burden of complications such as cardiovascular disease, kidney failure, neuropathy, retinopathy, and psychiatric comorbidities remains high. These complications significantly affect prognosis, quality of life, and health care utilization, underscoring the urgent need for deeper understanding and improved management strategies.

This Special Issue will collate original research articles, comprehensive reviews, and perspectives that address the biological mechanisms, clinical trajectories, and outcomes of T1D complications. We especially welcome studies that integrate real-world data, translational approaches, and innovative therapeutic or preventive strategies. By highlighting the interplay between disease pathology, complications, and prognosis, this Special Issue will advance knowledge that can inform precision medicine and improve long-term outcomes for individuals living with T1D.

We look forward to receiving your contributions.

Dr. Tadesse Melaku Abegaz
Guest Editor

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Keywords

  • type 1 diabetes
  • complications
  • prognosis
  • cardiovascular disease
  • neuropathy
  • retinopathy
  • nephropathy
  • disease mechanisms
  • clinical outcomes

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Published Papers (1 paper)

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Review

17 pages, 490 KB  
Review
The Impact of Diabetes on Brain Health in Childhood
by László Barkai
Biomedicines 2026, 14(3), 721; https://doi.org/10.3390/biomedicines14030721 - 20 Mar 2026
Viewed by 1245
Abstract
Background/Objectives: The global incidence of diabetes in childhood is increasing, raising concern about its long-term effects on the developing brain. Although paediatric diabetes research has traditionally focused on microvascular and macrovascular complications, accumulating evidence indicates that the brain is also a vulnerable target. [...] Read more.
Background/Objectives: The global incidence of diabetes in childhood is increasing, raising concern about its long-term effects on the developing brain. Although paediatric diabetes research has traditionally focused on microvascular and macrovascular complications, accumulating evidence indicates that the brain is also a vulnerable target. Methods: This narrative review synthesizes current knowledge on the impact of diabetes on brain health in children and adolescents, with emphasis on epidemiology, neuroimaging and cognitive outcomes, underlying mechanisms, risk and protective factors, and clinical implications. Results: In type 1 diabetes (T1D), studies consistently demonstrate subtle but measurable alterations in brain structure, including reduced growth of total, grey, and white matter volumes, alongside functional and microstructural changes. These neurobiological differences are associated with mild deficits in cognition, particularly in attention, executive function, memory, and processing speed. While clinically significant impairment affects a minority, subclinical alterations are common and may accumulate over time. Key risk factors include chronic hyperglycaemia, glycaemic variability, severe hypoglycaemia, diabetic ketoacidosis, and younger age at onset, whereas good glycaemic stability, diabetes technologies, supportive psychosocial environments, and adequate sleep appear protective. Proposed mechanisms involve oxidative stress, neuroinflammation, disrupted insulin signalling, altered cerebral metabolism, and vulnerability of the immature brain during critical developmental windows. Type 2 diabetes (T2D), increasingly diagnosed in youth, is also associated with adverse brain outcomes. Emerging data link early-onset T2D to alterations in brain structure and connectivity, poorer cognitive performance, and increased mental health burden, mediated by hyperglycaemia, insulin resistance, inflammation, and psychosocial stressors. Conclusions: Overall, childhood diabetes—both T1D and T2D—is associated with meaningful effects on brain development and function. Longitudinal and interventional studies are needed to establish causality and determine whether optimizing glycaemic control and psychosocial support can mitigate neurocognitive risk. Recognizing brain health as a potential complication of paediatric diabetes has important implications for monitoring, prevention, and clinical care. Full article
(This article belongs to the Special Issue Pathology, Complications, and Prognosis of Type 1 Diabetes (T1D))
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