Preface

The discovery of the hormone insulin by Frederick Banting and colleagues in the early 1920's is one of the greatest medical breakthroughs and has saved millions of lives over the years. The significance of the discovery is underscored by the fact that type 1 diabetics still have an absolute requirement for daily injections of insulin to live. Clearly, today's insulin treatments have attained levels of sophistication that have greatly improved clinical out‐ come compared to early days. Nevertheless, there are still complications associated with current standard of care and there is a pressing need for new means of treating and prevent‐ ing the disease.

This book consists of a collection of chapters that provide a broad overview of our current knowledge of different aspects of type 1 diabetes. Type 1 diabetes is an autoimmune disease and the result of the dysfunction and ultimately destruction of insulin-secreting pancreatic beta cells, which is mediated by immune cells of the host that have lost tolerance for the beta cells. We still do not know how the autoimmune process is initiated. A body of evidence points to multiple genetic and environmental factors, and it is likely that different combina‐ tions of these factors can cause disease onset. Insulin must be administered once critical beta cell function is lost but the treatment does not faithfully mimic changes in physiological lev‐ els of the hormone, which can result in severe complications. Much can and should be done to help individuals coping with the consequences of type 1 diabetes, in particular children who are a main target of the disease. On a higher note, it is anticipated that the clinical com‐ plications and loss of quality of life experienced by individuals with type 1 diabetes will be greatly alleviated and possibly eliminated with upcoming therapies that stop pathological autoimmunity and replace beta cells mass using different means. All these important topics are covered in the book, which we hope you will find a valuable source of information.

> Editor : **Alan Escher** SEKRIS Biomedical Inc., Redlands, California, USA

Co-Editor : **Alice Li** Loma Linda University, Loma Linda, California, USA

**Section 1**

**Epidemiology and Etiology**

**Epidemiology and Etiology**

**Chapter 1**

**The Epidemiology of Type 1 Diabetes Mellitus**

Type 1 diabetes mellitus (type 1 diabetes, insulin-dependent diabetes mellitus), one of the most common chronic diseases in childhood, is caused by insulin deficiency following autoimmune destruction of the pancreatic beta cells. Until the one and only therapeutic option – the life-long supplementation of insulin or its analogues – was established, affected children died within a short time. Although extensive investigations on the pathogenesis of type 1 diabetes have been performed, the underlying causes and mechanisms are still far from be‐ ing completely understood. The consequence is a lack of prevention strategies or causal

Great affords have been made to assess the incidence and prevalence of type 1 diabetes. The epidemiology of type 1 diabetes is estimated with different methods ranging from small cross-sectional studies to nationwide registries. Understanding the epidemiology of type 1 diabetes may identify risk factors, e.g. genetic predisposition or environmental factors, and may thereby elucidate the pathogenesis of type 1 diabetes. This could be one way to estab‐ lish possible preventive or causal therapeutic strategies. However, the findings on the possi‐ ble trigger factors of type 1 diabetes and its epidemiology are sometimes controversial or

In the present chapter, the incidence and prevalence of type 1 diabetes during the last decades will be described. Some fundamental facts about the estimation of type 1 diabe‐ tes epidemiology may facilitate understanding. The epidemiologic patterns of type 1 dia‐ betes regarding geographic differences, gender and age of the patients, as well as seasonal and ethnic factors in populations are summarized. The expected changes in type 1 diabetes epidemiology and its implications on future research directions and health

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© 2013 Frese and Sandholzer; licensee InTech. This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

© 2013 The Author(s). Licensee InTech. This chapter is distributed under the terms of the Creative Commons Attribution License http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution,

Thomas Frese and Hagen Sandholzer

http://dx.doi.org/10.5772/52893

**1. Introduction**

therapies.

even contradictory.

care are mentioned.

Additional information is available at the end of the chapter
