The Epidemiology And Progress In Treatment Of Children With Type 1 Diabetes

Type 1 diabetes is an autoimmune disease that the islet β cell is destructed and failed to secret enough insulin.It is one of the most common chronic diseases among children,and the incidence rate shows an increasing trend.The results of investigations concerning type 1 diabetes’ incidence rates of children and adolescents between sexes vary among different areas.There are also no consistent findings about the relationship between the incidence of T1 DM and birth month.But many studies have shown that children are more inclined to be attacked by type 1 diabetes in colder season rather than summer.The peak age of onset of type 1 diabetes is between 10 years old to 14 years old,that is to say that children in adolescence have the highest morbidity.However,the low age group has the fastest rising incidence,which also means that the younger age trend of the future onset of T1 DM among children.There are differences in urban and rural areas of the incidence of childhood T1 DM.The pathogenesis of Type 1 diabetes is complex.It is the result of the combined effects of genetic and environmental factors.Genetic susceptibility of type 1 diabetes is mainly associated with the human leukocyte antigen(HLA)that locates on chromosome 6.Not all people with a high genetic susceptibility will develop T1 DM,for the environmental factors also play an important role,which include viral infections,intake level of vitamin D,feeding styles in early and other factors,such as the age of the mother when was pregnant,toxicant exposure history,occupational exposure during pregnancy and so on.Treatment of type 1 diabetes has always posed a challenge to balance hyperglycemia control with hypoglycemia episodes.The treatment of insulin was started in 1923,and people have realized that the vast majority of children with type 1 diabetes were dead within one year before the discovery of insulin.In addition to the traditional "five carriages",the quest for newer therapies is continuing.The insulin molecule itself has got moulded into different analogues by minor changes in its structure to ensure more stable half-lives and lesser side effects.Insulin delivery systems have also consistently undergone advances from subcutaneous injections to continuous infusion to trials of inhalational delivery.Continuous glucose monitoring systems are also becoming more accurate and convenient for users.Smartphones have also made their entry into therapy of diabetes by integrating blood glucose levels and food intake with calculated adequate insulin required.Closed loop system can automatically adjust insulin dosage through real-time monitoring of blood glucose levels.Islet,pancreas-kidney and stem cells transplants are also being attempted though complete success is still a far way off.Insulin gene therapy is another new treatment of type 1 diabetes,but it is still at the exploratory stage of ideal vectors and target cells.Finally,prevention is better than cure,and immunological methods are being investigated to be used as vaccine to prevent the onset of diabetes mellitus.This review mainly attempts to outline the incidence,pathogenesis and treatment of type 1 diabetes.