Latest overview of type 1 diabetes mellitus

Type 1 diabetes mellitus (T1DM) was defined as a heterogeneous disorder characterized by severe beta-cell loss. The subtype 1A is characterized by abnormal autoimmue-mediated response and 1B is idiopathic etiology, and most of patients with T1DM are classified in 1A. There are three subtypes characterized by onset, fulminant, acute onset and slowly progressive in T1DM. Among these three subtypes, there are differences in genetic etiology, pathogenesis and prevalence of autoantibodies. Glutamic acid decarboxylase-65 (GAD65), insulinoma-associated antigen-2 (IA-2) and insulin are major autoantigens in T1DM and autoantibodies for former two are frequently used for clinical diagnosis. Also novel autoantibodies for T1DM have been found and clinical characteristics of the patients with each antibody will be made clearer. There have been eager efforts to develop immunotherapies to prevent islet destruction and to cure the disorder with islet transplantation, and new treatment with inhaled insulin regimen. Continuous glucose monitoring system(CGMS) has been established to make clearer the daily profile of blood glucose of the patients and to improve the metabolic control. Most efficient treatment for T1DM is a still insulin injection. However, the development of new medical devices and novel treatment rather than insulin injection has been done and the progression will promise improved prognosis of vascular complications.