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Diabetes mellitus type 1
What's new
Updated 2025 ADA guidelines for the diagnosis and management of type 1 diabetes .
Background
Overview
Definition
T1DM is an endocrine disorder characterized by T-cell mediated autoimmune destruction of insulin-producing beta cells in the pancreas, resulting in insulin deficiency with resultant hyperglycemia and a predisposition to ketoacidosis.
1
Pathophysiology
The cause of T1DM is mostly autoimmune destruction of beta cells of the pancreas (70-90%) and idiopathic (10-30%).
2
Epidemiology
The annual incidence of T1DM in the US is 22.9 per 100,000 person-years.
3
Disease course
Environmental triggers in genetically predisposed people lead to the production of autoantibodies against insulin-producing islet beta cells of the pancreas resulting in autoimmune destruction of these cells. This leads to insulin insufficiency and overt hyperglycemia, T1DM and its complications, diabetic ketoacidosis, altered mental status, coma, and death.
4
Prognosis and risk of recurrence
On average, the life expectancy of a person with T1DM is approximately 12 years less than the general population.
5
Guidelines
Key sources
The following summarized guidelines for the evaluation and management of diabetes mellitus type 1 are prepared by our editorial team based on guidelines from the American Diabetes Association (ADA 2025), the European Society of Cardiology (ESC 2023), the European Society of Hypertension (ESH 2023), the Endocrine Society (ES 2022,2020,2016), the Kidney Disease: Improving Global Outcomes Foundation (KDIGO 2022,2020), the Society ...
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