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<p>In recent years, significant progress has been made in the treatment of type&#xa0;1 diabetes thanks to the introduction of new insulin analogues and major developments in diabetes technology. One major innovation is continuous glucose monitoring (CGM). It provides continuous data on glucose levels, enables early warnings of hypoglycemia, and has been proven to improve glycemic control. CGM-based metrics such as “time in range” have now become established in clinical practice. In conjunction with so-called smart pens, CGM data are used directly to calculate and document insulin doses, which can make therapy much easier. Hybrid automatic insulin delivery (AID) systems represent another milestone in the treatment of type&#xa0;1 diabetes. They improve both glycemic control and quality of life and are now considered the standard therapy for children and adolescents. Hybrid AID therapy is also recommended for all adults with type&#xa0;1 diabetes who are unable to achieve their individual therapy goals with the current therapy. Future developments such as bi-hormonal or fully automated AID systems promise almost independent regulation of blood glucose levels and could enable a&#xa0;“technical cure” for type&#xa0;1 diabetes in the medium term.</p><p>Particularly in cases where obesity or metabolic syndrome is also present, the administration of metformin, glucagon-like peptide(GLP)-1 analogues, or sodium dependent glucose-linked transporter(SGLT)-2 inhibitors in conjunction with insulin therapy may be useful, but due to the lack of approval for type&#xa0;1 diabetes, this is currently only possible as off-label use.</p><p>Immunomodulatory therapies are becoming increasingly important in preventive approaches. Teplizumab is expected to receive European approval in 2026 and can delay the transition from the presymptomatic stage to the clinical manifestation of the disease by an average of two years. Other substances are currently being tested in clinical trials.</p><p>Stem cell-based therapies are a&#xa0;promising approach for a&#xa0;“biological cure” for type&#xa0;1 diabetes. In this approach, islet cells are differentiated from human pluripotent stem cells and transplanted. Initial studies show positive results with high rates of exogenous insulin independence. However, challenges remain in the need for lifelong immunosuppression and the lack of long-term and safety data.</p>

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Neue Therapieoptionen bei Diabetes mellitus Typ 1

  • 期刊论文

  • 发表日期：

    2025年11月3日

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  • Stephan Arndt

摘要

In recent years, significant progress has been made in the treatment of type 1 diabetes thanks to the introduction of new insulin analogues and major developments in diabetes technology. One major innovation is continuous glucose monitoring (CGM). It provides continuous data on glucose levels, enables early warnings of hypoglycemia, and has been proven to improve glycemic control. CGM-based metrics such as “time in range” have now become established in clinical practice. In conjunction with so-called smart pens, CGM data are used directly to calculate and document insulin doses, which can make therapy much easier. Hybrid automatic insulin delivery (AID) systems represent another milestone in the treatment of type 1 diabetes. They improve both glycemic control and quality of life and are now considered the standard therapy for children and adolescents. Hybrid AID therapy is also recommended for all adults with type 1 diabetes who are unable to achieve their individual therapy goals with the current therapy. Future developments such as bi-hormonal or fully automated AID systems promise almost independent regulation of blood glucose levels and could enable a “technical cure” for type 1 diabetes in the medium term.

Particularly in cases where obesity or metabolic syndrome is also present, the administration of metformin, glucagon-like peptide(GLP)-1 analogues, or sodium dependent glucose-linked transporter(SGLT)-2 inhibitors in conjunction with insulin therapy may be useful, but due to the lack of approval for type 1 diabetes, this is currently only possible as off-label use.

Immunomodulatory therapies are becoming increasingly important in preventive approaches. Teplizumab is expected to receive European approval in 2026 and can delay the transition from the presymptomatic stage to the clinical manifestation of the disease by an average of two years. Other substances are currently being tested in clinical trials.

Stem cell-based therapies are a promising approach for a “biological cure” for type 1 diabetes. In this approach, islet cells are differentiated from human pluripotent stem cells and transplanted. Initial studies show positive results with high rates of exogenous insulin independence. However, challenges remain in the need for lifelong immunosuppression and the lack of long-term and safety data.