Type 1 diabetes — master index¶
Last curated: 2026-08-30 · status: audited
The condition in five sentences. Type 1 diabetes is a chronic autoimmune disease in which T-cell-mediated destruction of pancreatic β cells produces lifelong dependence on exogenous insulin, and it is now formally staged as a continuum beginning years before symptoms: two or more islet autoantibodies define presymptomatic stage 1, and 69.7% of multiply-seropositive children progress to clinical disease within 10 years (Insel 2015, PMID 26404926; Ziegler 2013, PMID 23780460). About 8.4 million people lived with it worldwide in 2021 — most of them adults, with a median onset age of 39 — and prevalence is projected to grow 60–107% by 2040 (Gregory 2022, PMID 36113507). Intensive glycemic control prevents complications (DCCT 1993, PMID 8366922), and automated insulin delivery is now the technology anchor of care, raising time-in-range by ~11 percentage points in its pivotal trial (Brown 2019, PMID 31618560). The field crossed a historic threshold when teplizumab delayed clinical onset by a median ~2 years in at-risk relatives — the first approved disease-modifying therapy — and stem-cell-derived islets have now produced insulin independence in 10 of 12 early-trial recipients (Herold 2019, PMID 31180194; Reichman 2025, PMID 40544428). Yet burden remains stark: roughly two in five children worldwide still present in ketoacidosis, life expectancy is shortened by over a decade even in high-income registries, and a child diagnosed in a low-income country has a mean remaining life expectancy of 13 years versus 65 in a high-income one (Zhang 2026, PMID 42303108; Livingstone 2015, PMID 25562264; Gregory 2022, PMID 36113507).
Start here: overview.md. Frontier: OPEN-QUESTIONS.md. Growth history: LOG.md.
Build at a glance: 17 curated wiki pages · 259 unique PubMed records · 16 registry-verified clinical trials · 5 landmark paper notes · 22 guideline/consensus records · 72 statistics table rows · 6 verified patient organizations.
Reading paths¶
| Reader goal | Suggested path |
|---|---|
| Understand disease evolution | overview → staging → immunopathogenesis |
| Find and delay early disease | screening → biomarkers → immunotherapy |
| Understand current management | insulin and technology → hypoglycemia → complications |
| Survey the frontier | clinical trials → β-cell replacement → open questions |
| Center lived experience and safety | patient experience → psychosocial → red flags |
Pages¶
The canonical page list for this condition (per CONVENTIONS.md §5). All 17 pages passed the separate 2026-08-30 citation audit and are curated.
| File | Scope | Status |
|---|---|---|
| overview.md | What T1D is, staging framework, burden, map of the topic | curated |
| staging-and-natural-history.md | Stage framework, progression rates and birth cohorts | curated |
| epidemiology-and-burden.md | Global models, adult onset, mortality and DKA | curated |
| immunopathogenesis.md | T cells, insulitis, β-cell stress and immune-response evidence | curated |
| genetics-and-environmental-triggers.md | HLA/non-HLA risk and environmental hypotheses | curated |
| screening-and-early-detection.md | Relative/population screening, monitoring, ethics and economics | curated |
| insulin-therapy-and-technology.md | Insulin, CGM, pumps, AID and TIR | curated |
| disease-modifying-immunotherapy.md | Teplizumab, immune/β-cell therapy and combinations | curated |
| beta-cell-replacement.md | Pancreas/islet transplantation and stem-cell islets | curated |
| hypoglycemia.md | Severe hypoglycemia, awareness, rescue and technology | curated |
| complications.md | Micro-/macrovascular disease and DCCT/EDIC | curated |
| psychosocial-and-behavioral.md | Distress, eating, transition, caregivers and quality of life | curated |
| guidelines.md | ADA, ISPAD and NICE synthesis | curated |
| biomarkers.md | C-peptide, antibodies, genetics and progression scores | curated |
| clinical-trials-landscape.md | Prevention, replacement, technology and registered pipeline | curated |
| patient-experience-and-advocacy.md | Lived experience, organizations and access advocacy | curated |
| red-flags-and-safety-concerns.md | DKA, hypoglycemia, SGLT, driving and exercise safety | curated |
Literature layer¶
| Layer | Contents | Status |
|---|---|---|
| BIBLIOGRAPHY.md | 259 deduplicated cited PubMed records with reconciled cited-by mapping | audited |
| notes/ | 5 landmark paper notes | built |
| guidelines/REGISTRY.md | 22 guideline/consensus records, scope comparison, disagreements and watch list | audited |
| statistics/STATISTICS.md | 72 source-qualified table rows spanning burden, screening, treatment, replacement and psychosocial outcomes | deepened |
| patient-voice/ | Method, 6 verified organizations, themes and annotated sources | audited |
Curation state¶
This condition is audited (2026-08-30): all 17 canonical pages contain 150–212 lines, at least 25 live-verified PubMed citations, complete required sections, and no unresolved [unverified] flags. The dedicated audit re-fetched all 259 PMIDs, all 16 NCT records, and every public URL in the literature layer; curated records citation and substantive review, not clinical endorsement.