Type 1 diabetes is an autoimmune disease caused by the immune-mediated destruction of pancreatic β cells that results in lifelong absolute insulin deficiency. For nearly a century, insulin replacement has been the only therapy for most people living with this disease. Recent advances in technology and our understanding of β cell development, glucose metabolism, and the underlying immune pathogenesis of the disease have led to innovative therapeutic and preventative approaches. A paradigm shift in immunotherapy development toward the targeting of islet-specific immune pathways involved in tolerance has driven the development of therapies that may allow for the prevention or reversal of this disease while avoiding toxicities associated with historical approaches that were broadly immunosuppressive. In this review, we discuss successes, failures, and emerging pharmacological therapies for type 1 diabetes that are changing how we approach this disease, from improving glycemic control to developing the "holy grail" of disease prevention.

中文翻译：

---

治疗1型糖尿病的新领域。

1型糖尿病是由免疫介导的胰岛β细胞破坏引起的自身免疫疾病，导致终生绝对胰岛素缺乏。近一个世纪以来，胰岛素替代疗法一直是大多数患有这种疾病的人的唯一疗法。技术上的最新进展以及我们对β细胞发育，葡萄糖代谢和该疾病潜在的免疫发病机制的了解已导致了创新的治疗和预防方法。免疫疗法发展向耐受性相关的胰岛特异性免疫途径靶向的范式转变，推动了疗法的发展，该疗法可预防或逆转该疾病，同时避免了与广泛免疫抑制的历史方法相关的毒性。在这篇评论中，我们讨论成功，失败，