Etiopatogenia y situación epidemiológica de la diabetes mellitus tipo 1

Abstract

Type 1 diabetes mellitus (DM1) accounts for 5%-10% of diabetes cases worldwide. In most patients, the pathogenesis is the autoimmune destruction of pancreatic beta cells; in a small percentage, the origin is idiopathic. Although its onset is more common in children, it can also appear in adults, in whom the course is usually slower. Three phases or stages of DM1 have been defined. Virtually all patients with two or more antibodies will develop clinical DM1 (stage 3). In regard to DM1 prevention, there are multiple therapies under study that are aimed at halting the immunologic process or preserving the beta cell. Only teplizumab has been approved by the FDA in stage 2 DM1. The typical clinical symptoms in the diagnosis of DM1 is diabetic ketoacidosis (DKA), which is considered a medical emergency that requires the administration of insulin for its resolution. The determination of autoantibodies in relatives of patients with DM1 has increased the detection of cases of preclinical or asymptomatic DM1 and the need for universal screening for DM1 is being proposed.