Typ-1-Diabetes

Background. In 2018, atotal of 1917 articles were published in German or English on the topic of type1 diabetes mellitus (DM). The most important of these publications with implications for daily practice are summarized in this article. Results. The major trend in the treatment of type1 DM continued: enormous progress was made in partial closed-loop systems (partial=only the basal insulin substitution is regulated automatically); however the results from astudy on acomplete closed-loop system was disappointing with increased blood glucose levels during the daytime in the presence of ahigh number of hypoglycemic episodes. In the future, these systems will further reduce the efforts in the field of prevention and islet transplantation. The first randomized, controlled study in this field show disappointing results with asuccess rate of 24% after 1year, bleedings in 7% of the patients and decreases in the eGFR (estimated glomerular filtration rate) due to immunosuppressive medications. In 2studies, the treatment of patients with type1 DM with SGLT-2 inhibitors (SGLT: sodium-dependent glucose transporter) in doses commonly used in type2 DM again resulted in high rates of additional ketoacidosis (about 2% of patients/year). Surprisingly one study group treated with empagliflozin 2.5mg/day showed no increase in ketoacidosis, but still small metabolic effects were found.