Review Title :Novel Therapies For Type 1 Diabetes Mellitus

Type 1 diabetes mellitus (T1DM) is a chronic autoimmune disease of the progressive destruction of pancreatic β-cells, leading to severe insulin deficiency and persistent hyperglycemia. Treatment consists primarily of insulin therapy and a combination of glucose monitoring, dietary control, and exercise, which need to be done for a lifetime. Insulin therapy is necessary for survival but fails to restore β-cell function or directly inhibit the autoimmune process. In recent years, significant steps have been made in diabetes research which has translated into new therapies that will help improve glucose control, preserve or regenerate β-cells and minimize the need for insulin therapy. Immunotherapy, stem cell transplants, pancreatic islet transplants, encapsulated β-cell transplants, gene therapy, artificial pancreas and closed-loop systems, glucose-responsive insulin, β-cell regeneration, and new drug-based therapies are some of these approaches. Several of the therapies are currently in clinical use, including automated insulin delivery systems and some immunotherapies, and others are being studied, including cell-based, gene-based, and regenerative therapies. While they have the potential to be very beneficial, there are problems such as high cost, immune rejection, limited availability, long-term safety, immunosuppression and ethical concerns which limit their use. This review summarizes the current understanding of the pathophysiology and traditional treatments of T1DM, and outlines the mechanisms, potential benefits, limitations and current progress of emerging treatments. These advances could help usher in a future where the management of T1DM transcends insulin replacement and becomes more effective and possibly disease-modifying treatment options.