Type 1 diabetes mellitus: the liver’s role, sex-specific outcomes, and advances in disease-modifying therapies - a literature review

Type 1 Diabetes Mellitus (T1DM) is a chronic autoimmune disease characterized by the destruction of pancreatic β-cells, leading to insulin deficiency. While insulin remains the cornerstone of treatment, achieving optimal disease control and preventing long-term complications remain significant challenges. This review synthesizes recent findings on the epidemiology, pathophysiology, and management of T1DM, with a particular focus on sex-based differences in disease presentation and outcomes, the role of the liver, and the emerging significance of C-peptide in understanding disease complications. Additionally, the involvement of T cells and B cells in the immune response and the potential of disease-modifying therapies, such as TNF-alpha inhibitors, anti-CD3 antibodies, abatacept, and cell-based therapies, are explored. The article highlights the need for further research into personalized and gender-specific treatment approaches and the development of novel therapeutic strategies. Addressing these critical areas may lead to improved disease management and quality of life for individuals with T1DM, paving the way for more effective and individualized therapeutic interventions.