Type 1 Diabetes Mellitus: Epidemiology, Pathogenesis, Disease Staging and Emerging Therapeutic Strategies

Abstract

Background and aims:
Type 1 diabetes mellitus (T1DM) is a heterogeneous autoimmune disorder characterized by immune-mediated β-cell destruction and lifelong insulin dependence, with a rising global incidence. This review summarizes current evidence on its epidemiology, immunopathogenesis, disease staging, and emerging therapeutic strategies
Methods:
A narrative review of the literature was undertaken using articles from peer-reviewed journals in prominent scientific databases. The evidence with respect to trends in epidemiology, genetic and environmental risk factors, immunopathogenesis, autoantibody profiles, presymptomatic disease staging, clinical manifestations, and progress in therapeutic approaches was carefully evaluated. Special attention was given to disease heterogeneity, advances in translation and the current practice in India in the setting of socioeconomic and healthcare infrastructure challenges.
Conclusions:
T1DM is a complex, heterogeneous autoimmune disease characterized by a prolonged presymptomatic phase and evolving understanding of genetic and immunological mechanisms. Emerging advances in precision medicine, immunotherapy, and regenerative strategies offer promising avenues for disease modification, although equitable access and healthcare challenges remain, particularly in developing countries.