Type 1 diabetes-new aspects for treatment and technology 2023

Using mathematical epidemiological models, post hoc analyses indicate that the number of patients with type 1 diabetes (T1D) will increase significantly by 2040, with corresponding challenges for in- and outpatient care providers. Based on estimated prevalence rates, there are currently more people worldwide living with T1D aged > 60 years than aged < 20 years. A recent study has demonstrated the safety of insulin degludec during pregnancy in women with T1D, thereby aiding decision-making and extending the options for the choice of insulins for multiple daily injection (MDI) therapy during pregnancy. For continuous glucose monitoring (CGM) and automated insulin delivery (AID) systems, many studies have shown that CGM can improve patients' time in range (TIR) and glycated hemoglobin (HbA(1c)) levels. AID systems were shown to be superior to MDI therapy also in terms of quality of life and safety. Despite a lack of regulatory approval, open-source AID systems showed similar positive effects to commercially developed, approved AID systems. In a small proof-of-concept trial, favorable glycemic profiles were observed in patients with T1D treated with sodium-glucose linked transporter 2 (SGLT2) inhibitors as an add-on to AID therapy.