Epidemiology and Pathogenesis of Type 1 Diabetes

Type 1 diabetes is an autoimmune disease that affects 0.1 to nearly 1% of the population, dependent on the country, with its highest incidence around 10–15 years of age. The incidence has increased over time, approximately doubling over the past 2–3 decades. The incidence varies across the world, with the highest among populations of (Northern) European origin and the lowest in Japan. Most diabetic patients do not have affected first-degree relatives, but genetic predispostion encoded in the HLA class II DR- and DQ loci is proabably necessary, albeit not sufficient, for developing disease. Exposure to environmental factors in early life appears to also impact the risk of disease development, but available evidence does not allow for strong conclusions to be drawn. The past decade has brought new data from human pancreatic donors. Hoewever, the timing between etiological triggers and the pathogenesis is poorly defined, and the disease mechanisms need to be elucidated. It is still not possible to prevent or cure type 1 diabetes. The latter can currently only be achieved using invasive beta-cell repacement therapies through transplantation