Abstract
Objective: To evaluate the main updates on the influence of diabetes mellitus (DM1) in pregnancy, cardiovascular diseases and COVID-19, as well as the genetics and treatment of the disease. Bibliographic review: DM1 is a complex autoimmune condition, marked by the loss of pancreatic β cells, leading to insufficient insulin production. Its incidence has grown worldwide since the 1950s, increasing between 3% and 4% in the last three decades. DM1 has significant implications for conditions such as hypertension, peripheral and coronary artery disease, and its carriers may be at greater risk for complications related to COVID-19. Pregnant women with T1D present adverse obstetric and neonatal risks. Treatment of the disease involves the administration of insulin and recent advances have focused on promoting better glycemic control and reducing the risk of complications. Final considerations: The early diagnosis and treatment of DM1 reflects on the morbidity and mortality of patients, as it avoids complications during the development of other simultaneous diseases and improves the quality of life of people with it. It is extremely important that the multidisciplinary team stays up to date and searches for innovations about the disease.
References
AKIL AA, et al. Diagnosis and treatment of type 1 diabetes at the dawn of the personalized medicine era. J Transl Med, 2021; 19(1): 137.
AMERICAN DIABETES ASSOCIATION. Classification and Diagnosis of Diabetes: Standards of Medical Care in Diabetes-2020. Diabetes Care, 2020; 43(1): 14-31.
BARRETT CE, et al. Risk for Newly Diagnosed Diabetes >30 Days After SARS-CoV-2 Infection Among Persons Aged <18 Years - United States, March 1, 2020-June 28, 2021. MMWR Morb Mortal Wkly Rep, 2022; 71(2): 59-65.
BECK RW, et al. Effect of Continuous Glucose Monitoring on Glycemic Control in Adults With Type 1 Diabetes Using Insulin Injections: The DIAMOND Randomized Clinical Trial. Jama, 2017; 317(4): 371-378.
BENHALIMA K, et al. Management of type 1 diabetes in pregnancy: update on lifestyle, pharmacological treatment, and novel technologies for achieving glycaemic targets. Lancet Diabetes Endocrinol, 2023; 11(7): 490-508.
Chen S, Du K, Zou C. Current progress in stem cell therapy for type 1 diabetes mellitus. Stem Cell Res Ther. 2020 Jul 8;11(1): 275.
CICHOCKA E, et al. Adjuvant therapy in type 1 diabetes mellitus. Endokrynol Pol, 2021; 72(1): 87-88.
COBAS R, et al. Diagnóstico do diabetes e rastreamento do diabetes tipo 2. Diretriz Oficial da Sociedade Brasileira de Diabetes. 2023. Disponível em: https ://diretriz.diabetes.org.br/diagnostico-e-rastreamento-do-diabetes-tipo-2/#citacao. Acessado em: 31 de março de 2024.
DIMEGLIO LA. COVID-19 and Type 1 Diabetes: Addressing Concerns and Maintaining Control. Diabetes Care, 2021; 44(9): 1924-1928.
DINNYES A, et al. Integration of nano- and biotechnology for beta-cell and islet transplantation in type-1 diabetes treatment. Cell Prolif, 2020; 53(5): 12785.
DOST A, et al. 2017 American Academy of Pediatrics Clinical Practice Guideline: Impact on Prevalence of Arterial Hypertension in Children and Adolescents With Type 1 Diabetes. Diabetes Care, 2020; 43(6): 1311-1318.
ELIASSON B, et al. The significance of chronic kidney disease, heart failure and cardiovascular disease for mortality in type 1 diabetes: nationwide observational study. Sci Rep, 2022; 12(1): 17950.
HAAK T, et al. Therapy of Type 1 Diabetes. Exp Clin Endocrinol Diabetes, 2019; 127(1): 27-38.
HELMAN A e MELTON DA. A Stem Cell Approach to Cure Type 1 Diabetes. Cold Spring Harb Perspect Biol. 2021; 13(1): 35741.
HOGREBE NJ, et al. Developments in stem cell-derived islet replacement therapy for treating type 1 diabetes. Cell Stem Cell, 2023; 30(5): 530-548.
IMAFUKU H, et al. Advantages of sensor-augmented insulin pump therapy for pregnant women with type 1 diabetes mellitus. J Diabetes Investig, 2023; 14(12): 1383-1390.
JAFFAR F, et al. Type 1 Diabetes in Pregnancy: A Review of Complications and Management. Curr Diabetes Ver, 2022; 18(7): 051121197761.
JULIÁN MT, et al. The double burden: type 1 diabetes and heart failure-a comprehensive review. Cardiovasc Diabetol, 2024; 23(1): 65.
LITHOVIUS R, et al. The many faces of hypertension in individuals with type 1 diabetes. Diabetes Res Clin Pract, 2023; 197: 110564.
LIU Z, et al. Causal associations between type 1 diabetes mellitus and cardiovascular diseases: a Mendelian randomization study. Cardiovasc Diabetol, 2023; 22(1): 236.
LORETELLI C, et al. Cell therapy for type 1 diabetes. Expert Opinion on Biological Therapy, 2020; 20(8): 887–897.
MCGLACKEN-BYRNE SM, et al. The SARS-CoV-2 pandemic is associated with increased severity of presentation of childhood onset type 1 diabetes mellitus: a multi-centre study of the first COVID-19 wave. Diabet. Med, 2021; 38(9): 14640.
NWOKOLO M e HOVORKA R. The Artificial Pancreas and Type 1 Diabetes. J Clin Endocrinol Metab. 2023; 108(7): 1614-1623.
PASTORE I, et al. The impact of diabetes mellitus on the onset of cardiovascular risk in children and teenagers. Int J Mol Sci, 2020; 21(14): 4928.
PENG X, et al. Preclinical models for Type 1 Diabetes Mellitus - A practical approach for research. Int J Med Sci, 2023; 20(12): 1644-1661.
PITOCCO D, et al. Lack of type 1 diabetes involvement in SARS-COV-2 population: Only a particular coincidence? Diabetes Res. Clin. Pract, 2020; 164: 108220.
PRATLEY RE, et al. Wireless Innovation for Seniors With Diabetes Mellitus (WISDM) Study Group. Effect of Continuous Glucose Monitoring on Hypoglycemia in Older Adults With Type 1 Diabetes: A Randomized Clinical Trial. JAMA. 2020; 323(23): 2397-2406.
PRIMAVERA M, et al. Prediction and Prevention of Type 1 Diabetes. Front Endocrinol (Lausanne), 2020; 11: 248.
QU HQ, et al. Improved genetic risk scoring algorithm for type 1 diabetes prediction. Pediatr Diabetes, 2022; 23(3): 320-323.
RANKIN D, et al. Rollout of Closed-Loop Technology to Pregnant Women with Type 1 Diabetes: Healthcare Professionals' Views About Potential Challenges and Solutions. Diabetes Technol Ther, 2023; 25(4): 260-269.
REDONDO MJ, et al. Type 1 diabetes in diverse ancestries and the use of genetic risk scores. Lancet Diabetes Endocrinol, 2022; 10(8): 597-608.
RODACKI M, et al. Classificação do diabetes. Diretriz Oficial da Sociedade Brasileira de Diabetes. 2023. Disponível em: https ://diretriz.diabetes.org.br/classificacao-do-diabetes/#citacao. Acessado em: 25 de março de 2024.
RODRIGUES OLIVEIRA SM, et al. Type 1 Diabetes Mellitus: A Review on Advances and Challenges in Creating Insulin Producing Devices. Micromachines (Basel). 2023;14(1): 151.
RUBINO F, et al. New-onset diabetes in Covid-19. New England Journal of Medicine, 2020; 383(8): 789-790.
SANCHEZ M, et al. Leukocyte telomere length, allelic variations in related genes and risk of coronary heart disease in people with long-standing type 1 diabetes. Cardiovasc Diabetol, 2022; 21(1): 206.
TANG X, et al. Fulminant type 1 diabetes after COVID-19 vaccination. Diabetes Metab, 2022; 48(2): 101324.
TOMMERDAHL KL, et al. Early microvascular complications in type 1 and type 2 diabetes: recent developments and updates. Pediatr Nephrol, 2022; 37(1): 79-93.
UNSWORTH R, et al. New-onset type 1 diabetes in children during COVID-19: multicenter regional findings in the U.K. Diabetes Care, 2020; 43(11): 170-171.
WEISS A, et al. Type 1 Diabetes Incidence and Risk in Children With a Diagnosis of COVID-19. JAMA, 2023; 329(23): 2089-2091.
YAPANIS M, et al. Complications of Diabetes and Metrics of Glycemic Management Derived From Continuous Glucose Monitoring. J Clin Endocrinol Metab, 2022; 107(6): 2221-2236.
