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Review
. 2025 Jan 10;14(2):418.
doi: 10.3390/jcm14020418.

Autoimmune Type 1 Diabetes: An Early Approach Appraisal for Spain by the AGORA Diabetes Collaborative Group

Fernando Gómez-Peralta  1 , Pedro J Pinés-Corrales  2 , Estefanía Santos  3 , Martín Cuesta  4 , Olga González-Albarrán  5 , Sharona Azriel  6 , Luis Castaño  7 , Chantal Mathieu  8 , On Behalf Of The Agora Diabetes Collaborative Group
Affiliations
Review

Autoimmune Type 1 Diabetes: An Early Approach Appraisal for Spain by the AGORA Diabetes Collaborative Group

Fernando Gómez-Peralta et al. J Clin Med. .

Abstract

Type 1 diabetes (T1D) is an autoimmune disorder characterized by the destruction of insulin-producing pancreatic beta-cells, leading to lifelong insulin dependence. This review explores the current understanding of T1D pathogenesis, clinical progression, and emerging therapeutic approaches. We examined the complex interplay between genetic predisposition and environmental factors that could trigger the autoimmune response as well as the immunological mechanisms involved in beta-cell destruction. The clinical phases of T1D are discussed from the preclinical stage through diagnosis and long-term management, highlighting the importance of early detection and intervention. Recent advancements in treatment strategies are presented, including immunomodulatory therapies and potential cell-based treatments aimed at preserving or restoring beta-cell function. Additionally, this review critically evaluates the feasibility and potential benefits of implementing a population-wide screening program for T1D in Spain. The epidemiological, economic, and ethical implications of such an initiative were considered by the national expert panel, focusing on the potential of early diagnosis to improve clinical outcomes in the face of the challenges of large-scale implementation. This comprehensive analysis aims to provide healthcare professionals, researchers, and policymakers with valuable insights into the current landscape of T1D management and prospects for enhanced prevention and treatment strategies in the Spanish context.

Keywords: Spain; autoimmune diabetes; disease stages; pathogenesis; pediatric population; prevention; screening; type 1 diabetes.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
How are beta-cells destroyed in T1D?
Figure 2
Figure 2
Definitions of stages of type 1 diabetes. * Dysglycemia defined according to the Consensus Guidance for Monitoring Individuals with Islet Autoantibody-Positive Pre-Stage 3 Type 1 Diabetes [11]. ** Because some patients are actually asymptomatic at the time that they cross the threshold for glucose-based criteria. From by permission [12].
Figure 3
Figure 3
Combined genetic/AA-based screening versus an AA-based approach. Adapted with permission from [12].
See this image and copyright information in PMC

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