Type 1 Diabetes

A special issue of Endocrines (ISSN 2673-396X). This special issue belongs to the section "Obesity, Diabetes Mellitus and Metabolic Syndrome".

Deadline for manuscript submissions: closed (31 December 2023) | Viewed by 18310

Special Issue Editor


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Guest Editor
Clinical Professor of Medicine, Stanford University Medical Center, Stanford, CA 94305, USA
Interests: type 1 diabetes; diabetes technology; diabetes in pregnancy; pancreatogenic diabetes

Special Issue Information

Dear Colleagues,

This is a Special Issue of top-quality papers published free of charge (APC = 0) in Open Access form. In this special year of the 100-year anniversary of insulin discovery, a true life-saving event for individuals with type 1 diabetes, we would like to devote this issue to updates in advances in insulin replacement therapy, automated insulin delivery systems, detection and prevention of short- and long-term complications, early detection and primary and secondary prevention, pancreas, and beta-cell transplantation.

The incidence of type 1 diabetes continues to rise with an annual rate of approximately 3% despite significant developments done in the field. It continues to be a significant burden to individuals who live with this condition 24/7. The goal of treatment is to balance clinical, humanistic, and economic burdens to improve patient quality of life and reduce complications.

Type 1 diabetes is a serious health priority all over the world. It is a chronic and life-threatening condition that has a life-long impact on affected individuals and their families. There are many gaps in all aspects of type 1 diabetes care, and, therefore, future directions should focus ultimately on curing this disease.

This Special Issue in Endocrines welcomes a wide range of clinical, basic science, technology, and transplantation-related studies and reviews related to type 1 diabetes. We thank you in advance for your contribution to this Special Issue on the 100-year anniversary of insulin discovery.

Dr. Marina Basina
Guest Editor

Manuscript Submission Information

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Keywords

  • type 1 diabetes
  • diabetes burnout
  • closed loop
  • beta-cell transplantation
  • pancreas transplantation
  • insulin costs
  • insulin pump
  • continuous glucose monitoring system

Published Papers (5 papers)

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Research

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9 pages, 531 KiB  
Article
Evaluating the Efficacy and Safety of Long-Acting GLP-1 Receptor Agonists in T1DM Patients
by Deene Mohandas, Jamie Calma, Catherine Gao and Marina Basina
Endocrines 2023, 4(1), 93-101; https://doi.org/10.3390/endocrines4010008 - 6 Feb 2023
Cited by 4 | Viewed by 8667
Abstract
(1) Background: Glucagon-like peptide 1 receptor agonists (GLP-1 RA) are a class of therapeutic agents that mimic the endogenous incretin hormone GLP-1. While this class of agents is not approved for Type 1 Diabetes (T1DM) due to concern of increased diabetic ketoacidosis (DKA) [...] Read more.
(1) Background: Glucagon-like peptide 1 receptor agonists (GLP-1 RA) are a class of therapeutic agents that mimic the endogenous incretin hormone GLP-1. While this class of agents is not approved for Type 1 Diabetes (T1DM) due to concern of increased diabetic ketoacidosis (DKA) risk, long-acting GLP-1 medications are being commonly prescribed off label for T1DM in clinical practice. Several studies addressed the efficacy and safety of short-acting GLP-1 agonists therapy in patients with T1DM, but the data on long-acting agents are lacking. In our study, we aim to fill in this gap and help healthcare providers in their clinical decision making on the use of these agents for T1DM patients. (2) Methods: We conducted a retrospective chart review of T1DM patients on a long-acting GLP-1 for at least six months. Our retrospective chart review included information starting two years prior to starting GLP-1, and six or more months after starting GLP-1. Parameters collected included HbA1c, 14-day Continuous Glucose Monitor (CGM) and blood glucose (BG) data, and metabolic data (weight, systolic and diastolic blood pressure, and cholesterol levels). Statistical analysis was conducted using paired t-tests on R and Excel with α of 0.05. (3) Results: Our cohort consisted of 54 participants with T1DM on a long-acting GLP-1 (semaglutide, dulaglutide, exenatide extended-release [ER], albiglutide). Mean GLP-1 treatment duration was 23.85 ± 15.46 months. HbA1c values decreased significantly by an average of 0.71% percentage points (%-points, p = 0.002) comparing pre-therapy vs. on GLP-1 treatment. Similarly, for pre-therapy vs. on GLP-1 treatment values, CGM results were significant for increased time in range by 12.15%-points (p = 0.0009) showing a decreased average time in hyperglycemia (BG > 180 mg/dL) by a mean difference of 11.97%-points (p = 0.006), decreased 14-day mean BG by 19 mg/dl (p = 0.01), decreased 14-day BG standard deviation by 8.45 mg/dl (p = 0.01), decreased incidence of DKA hospitalization, and a decrease in weight by 3.16 kg (p = 0.007). (4) Conclusions: As more data emerges on cardiovascular and renal benefits of long acting GLP-1 in type 2 diabetes, there have been no reported outcomes in T1DM. Our study is the first to demonstrate glycemic and metabolic benefits of this class of medication as an adjunct therapy to insulin in T1DM, and safety of its use over an average of 1.5–2 years’ time. This study represents real life experience and the data warrants confirmation by additional prospective studies. Full article
(This article belongs to the Special Issue Type 1 Diabetes)
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8 pages, 1170 KiB  
Article
Serum IL-1ra Is Associated with but Has No Genetic Link to Type 1 Diabetes
by Paul M. H. Tran, Fran Dong, Khaled Bin Satter, Katherine P. Richardson, Roshni Patel, Lynn K. H. Tran, Diane Hopkins, Ravindra Kolhe, Kathleen Waugh, Marian Rewers and Sharad Purohit
Endocrines 2022, 3(3), 570-577; https://doi.org/10.3390/endocrines3030048 - 13 Sep 2022
Viewed by 1739
Abstract
Interleukin-1 antagonism is a proposed biomarker and potential therapy for the delay and/or treatment of type 1 diabetes (T1D). We evaluated the role of circulating interleukin-1 receptor antagonist (IL-1ra) in a prospectively monitored cohort of T1D patients. In order to determine a mechanistic [...] Read more.
Interleukin-1 antagonism is a proposed biomarker and potential therapy for the delay and/or treatment of type 1 diabetes (T1D). We evaluated the role of circulating interleukin-1 receptor antagonist (IL-1ra) in a prospectively monitored cohort of T1D patients. In order to determine a mechanistic association between IL-1ra and T1D, we performed co-localization analyses between serum IL-1ra protein quantitative trait loci and T1D genome-wide analysis studies. Adjusting for human leukocyte antigen (HLA) genotypes, first degree relative status, gender, and age, serum levels of IL-1ra were lower in subjects who progressed to T1D compared to the controls (p = 0.023). Our results suggest that females have higher levels of IL-1ra compared to males (p = 0.005). The 2q14.1 region associated with serum IL-1ra levels is not associated with a risk of developing T1D. Our data suggest that IL-1 antagonism by IL-1ra is not an effective therapy in T1D, but IL-1ra may be a biomarker for progression to T1D. Full article
(This article belongs to the Special Issue Type 1 Diabetes)
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8 pages, 344 KiB  
Article
Patient Perspectives on Use of Video Telemedicine for Type 1 Diabetes Care in the United States during the COVID-19 Pandemic
by Stephanie S. Crossen, Crystal C. Romero, Lindsey A. Loomba and Nicole S. Glaser
Endocrines 2021, 2(4), 449-456; https://doi.org/10.3390/endocrines2040040 - 1 Nov 2021
Cited by 14 | Viewed by 3253
Abstract
The COVID-19 pandemic has resulted in widespread adoption of telemedicine for management of chronic conditions such as type 1 diabetes (T1D), but few data have been collected about the patient experience and perceived quality of care during this time. We surveyed members of [...] Read more.
The COVID-19 pandemic has resulted in widespread adoption of telemedicine for management of chronic conditions such as type 1 diabetes (T1D), but few data have been collected about the patient experience and perceived quality of care during this time. We surveyed members of the T1D Exchange patient registry and online community regarding their experiences with and opinions about telemedicine care during the pandemic. Among 2235 survey respondents, 65% had utilized telemedicine. The most common reasons for adopting telemedicine were providers not offering in-person care (66%), concerns about the health risks of in-person care (59%), providers offering (52%) or insurance covering (19%) telemedicine for the first time, and local or state orders to stay home (33%). Among telemedicine users, 62% felt video care was as effective as or more effective than in-person care, and 82% hoped to use telemedicine in the future. The most-cited reason for non-use of telemedicine was that providers were not offering it (49%). Our findings highlight the role of telemedicine in maintaining access to T1D care during the COVID-19 pandemic. Respondents’ satisfaction with telemedicine and interest in its continued use signifies the need for ongoing access to this care modality and for the development of telemedicine best practices within T1D care. Full article
(This article belongs to the Special Issue Type 1 Diabetes)
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Review

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11 pages, 265 KiB  
Review
Which Diabetes Patients Will Benefit the Most from Once-Weekly Basal Insulin Analogs? A Review with a Special Focus on Type 1 Diabetes Patients
by Chrysoula Kosmeri, Maria Baltogianni, Vasileios Giapros, Ekaterini Siomou, Vasiliki-Regina Tsinopoulou, Foteini Balomenou and Anastasios Serbis
Endocrines 2024, 5(2), 214-224; https://doi.org/10.3390/endocrines5020015 - 9 May 2024
Viewed by 673
Abstract
Basal insulin analogs, typically administered once or twice daily, have been one of the two pillars of the multiple daily injection (MDI) insulin therapy of patients with type 1 diabetes (T1D) for the last twenty years. Recently, once-weekly basal insulin analogs have been [...] Read more.
Basal insulin analogs, typically administered once or twice daily, have been one of the two pillars of the multiple daily injection (MDI) insulin therapy of patients with type 1 diabetes (T1D) for the last twenty years. Recently, once-weekly basal insulin analogs have been developed and are in late-phase clinical trials. One of these analogs is insulin icodec (icodec), appropriately developed to bind reversibly to albumin and to be gradually released into the patient’s circulation. Icodec has been tried mostly in clinical trials of adult patients with type 2 diabetes. A recent phase 3a clinical trial comprising adult patients with T1D was designed to evaluate icodec’s efficacy and safety compared with a daily basal insulin analog (degludec) after a 26-week main phase plus a safety extension of another 26 weeks. Icodec showed non-inferiority to once-daily degludec in glycated hemoglobin (HbA1c) reduction at week 26, and no significant differences in time in range (TIR) (70–180 mg/dL) and in time above range (TAR) (>180 mg/dL). On the other hand, it was associated with increased rates of clinically significant hypoglycemia (blood glucose < 54 mg/dL) and severe hypoglycemia (external assistance need for recovery), remaining either below or close to the internationally recommended targets for hypoglycemia. Another once-weekly insulin analog, basal insulin Fc (BIF), has been investigated in a phase 2 clinical trial comprising adult patients with T1D, with equally promising results. These preliminary data suggest that once-weekly insulin analogs could be of use for some patients with T1D, for example, patients not taking insulin regularly or those who are on MDI and wish for fewer injections. In addition, due to its prolonged mode of action, it could decrease the risk of diabetic ketoacidosis and the need for hospitalization. Additionally, patients with T1D that struggle with wearing diabetes mellitus devices/closed-loop insulin pumps either due to the cost or due to skin issues may also benefit from long-acting insulin. There is increasing evidence of the benefits of adjunctive therapies to insulin in T1D patients, but these therapies are not FDA-approved due to a possible higher risk of diabetic ketoacidosis. These long-acting insulin analogues could be used with adjunctive therapies in selected patients. This review aims to present available data on the mode of action, clinical trial results, and possible benefits of once-weekly insulin analogs for patients with T1D. In addition, it intends to suggest a future research framework for important clinical questions, such as once-weekly insulin analog use and exercise, sick days, or surgery, that will enhance our knowledge regarding this indisputable innovation in insulin management. Full article
(This article belongs to the Special Issue Type 1 Diabetes)
19 pages, 649 KiB  
Review
The Promising Role of Self-Compassion in Managing Type 1 Diabetes
by Chloe Kaelberer and Molly L. Tanenbaum
Endocrines 2023, 4(2), 293-311; https://doi.org/10.3390/endocrines4020024 - 26 Apr 2023
Cited by 2 | Viewed by 2846
Abstract
Given the demanding daily regimen for type 1 diabetes (T1D) and emphasis on personal responsibility for self-management, people with T1D can experience self-criticism and diabetes distress. How an individual responds to and copes with diabetes-related feedback may influence self-care, health outcomes, and overall [...] Read more.
Given the demanding daily regimen for type 1 diabetes (T1D) and emphasis on personal responsibility for self-management, people with T1D can experience self-criticism and diabetes distress. How an individual responds to and copes with diabetes-related feedback may influence self-care, health outcomes, and overall well-being. Self-compassion in the context of diabetes has limited but promising research on its ability to alleviate distress in people with T1D. This narrative review captures relevant, existing literature on self-compassion, compassion-based interventions, and T1D and describes four topic areas where diabetes-specific self-compassion and compassion-based interventions may be particularly relevant: (1) diabetes technology use; (2) relationship with eating and body image; (3) social interactions; and (4) healthcare interactions. Compassion-based interventions have the potential to enhance positive coping skills and to alleviate diabetes distress; more research is needed to understand the role of diabetes-specific self-compassion and to develop high-quality evidence-based interventions. Full article
(This article belongs to the Special Issue Type 1 Diabetes)
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