Autoimmune Type 1 Diabetes in the Era of Disease-Modifying Immune Therapy

Disease-modifying therapies have been used to treat the underlying causes of autoimmune diseases for over half a century. However, until recently, type 1 diabetes (T1D), the autoimmune form of diabetes, had not entered this therapeutic landscape. The approval of teplizumab, an anti-CD3 monoclonal antibody and the first disease-modifying therapy for use in individuals with preclinical T1D, has caused a major shift in the way healthcare providers can treat the T1D disease course. In this review, we discuss the chronic autoimmune nature of T1D and provide an overview of disease-modifying therapies that are under investigation to target the autoimmune mechanisms in T1D to preserve residual beta-cell function and prevent disease progression. The considerations for implementing these therapies into clinical practice are also discussed.