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The management of the disease remains primarily focused on its phenotypical presentation and less on endotypes, namely the specific biological mechanisms behind the development of the disease. Furthermore, the treatment of T1D is essentially universal and indiscriminate\u2014with patients administering insulin at varying dosages and frequencies to maintain adequate glycaemic control. However, it is now well understood that T1D is a heterogeneous disease with many different biological mechanisms (i.e. endotypes) behind its complex pathophysiology. A range of factors, including age of onset, immune system regulation, rate of \u03b2\u2010cell destruction, autoantibodies, body weight, genetics and the exposome are recognised to play a role in the development of the condition. Patients can be classified into distinct diabetic subtypes based on these factors, which can be used to categorise patients into specific endotypes. The classification of patients into endotypes allows for a greater understanding of the natural progression of the disease, giving rise to more accurate and patient\u2010centred therapies and follow\u2010up monitoring, specifically for other autoimmune diseases. This review proposes 6 unique endotypes of T1D based on the current literature. The recognition of these endotypes could then be used to direct therapeutic modalities based on patients' individual pathophysiology.<\/jats:p>","DOI":"10.1002\/dmrr.3770","type":"journal-article","created":{"date-parts":[[2024,2,7]],"date-time":"2024-02-07T02:44:33Z","timestamp":1707273873000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":34,"title":["Type 1 diabetes: A new vision of the disease based on endotypes"],"prefix":"10.1002","volume":"40","author":[{"given":"Craig Sinclair","family":"Weston","sequence":"first","affiliation":[{"name":"Barts and The London School of Medicine and Dentistry Queen Mary University of London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bernhard O.","family":"Boehm","sequence":"additional","affiliation":[{"name":"King's College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5090-636X","authenticated-orcid":false,"given":"Paolo","family":"Pozzilli","sequence":"additional","affiliation":[{"name":"Endocrinology and Metabolic Diseases Campus Bio\u2010Medico of Rome  Rome Italy"},{"name":"Centre of Immunobiology The Blizard Institute Barts and The London School of Medicine and Dentistry Queen Mary University of London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,2,5]]},"reference":[{"key":"e_1_2_16_2_1","doi-asserted-by":"publisher","DOI":"10.1172\/jci142239"},{"issue":"8","key":"e_1_2_16_3_1","first-page":"673","article-title":"The treatment of diabetes mellitus","volume":"6","author":"Joslin EP","year":"1916","journal-title":"Can Med Assoc J"},{"key":"e_1_2_16_4_1","unstructured":"MarkelH.How a boy became the first to beat back diabetes.2013. 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