{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T13:10:37Z","timestamp":1792588237879,"version":"4.5.0"},"reference-count":103,"publisher":"Wiley","issue":"S6","license":[{"start":{"date-parts":[[2025,6,19]],"date-time":"2025-06-19T00:00:00Z","timestamp":1750291200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["dom-pubs.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Diabetes Obesity Metabolism"],"published-print":{"date-parts":[[2025,8]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:label\/>\n                    <jats:sec>\n                      <jats:label\/>\n                      <jats:p>The prevalence of type 1 diabetes is increasing, with significant implications for public health systems worldwide. This review provides a global overview of the current epidemiology of type 1 diabetes, examining the trends, risk factors, and regional variations in incidence. We explore the influence of genetic, environmental, and socio\u2010economic factors on the rising incidence of type 1 diabetes. The review also highlights temporal trends in the management of type 1 diabetes and the risk of mortality and morbidity from acute and long\u2010term complications, including hypoglycaemia, diabetic ketoacidosis, and retinopathy. By synthesizing global and regional data, we aim to provide valuable insights for local health service planning, disease prediction, and tailored interventions. This article underscores the importance of continued research into the epidemiology of type 1 diabetes to better inform prevention, treatment, and management strategies of this growing global health challenge.<\/jats:p>\n                    <\/jats:sec>\n                    <jats:sec>\n                      <jats:title>Plain Language Summary<\/jats:title>\n                      <jats:p>Type 1 diabetes (T1D) is an autoimmune condition that begins silently, with the body attacking insulin\u2010producing cells in the pancreas. This process occurs in two early, silent stages, detectable through blood tests for antibodies, before symptoms appear. It eventually progresses to stage 3, when symptoms develop and insulin treatment becomes necessary.<\/jats:p>\n                      <jats:sec>\n                        <jats:title>Prevalence<\/jats:title>\n                        <jats:p>T1D affects about 9 million people globally, including over 1.5 million children. In addition to those with symptoms, many children and adults may unknowingly have early stage T1D. These can be detected through screening and are estimated to affect around 0.3% of the population.<\/jats:p>\n                      <\/jats:sec>\n                      <jats:sec>\n                        <jats:title>Incidence<\/jats:title>\n                        <jats:p>In 2024, there were over 500,000 new diagnoses of T1D worldwide, with cases increasing each year. Rates vary by region, age, and sex. Most diagnoses occur in childhood or early adulthood, with a peak around puberty, though it can develop later in life. Rates are highest in high\u2010income countries such as Finland and Australia. Lower rates in other regions may reflect limited surveillance. Some countries have reported fluctuating trends, possibly linked to infections. Improved awareness and diagnostics explain and changing risk factors may also play a role.<\/jats:p>\n                      <\/jats:sec>\n                      <jats:sec>\n                        <jats:title>Risk Factors<\/jats:title>\n                        <jats:p>The risk of T1D is impacted by genetic, demographic, and environmental factors. Family history increases risk, though the majority of people diagnosed don\u2019t have a family history. Genetic risk scores can also help identify children at higher risk. Risk changes with age, early signs often appear before age 3, and younger children tend to progress more quickly. Two childhood diagnosis peaks occur at ages 4\u20137\u2009years and 10\u201314\u2009years. Researchers are exploring possible subtypes of T1D based on age and disease behaviour. White European populations have the highest rates, but increases are also seen in other groups. Environmental factors like viral infections, caesarean birth, and early diet are being studied.<\/jats:p>\n                      <\/jats:sec>\n                      <jats:sec>\n                        <jats:title>Complications<\/jats:title>\n                        <jats:p>Managing T1D is complex, however poor control can lead to short\u2010term emergencies like hypoglycaemia or diabetic ketoacidosis (DKA), and long\u2010term complications affecting the eyes, kidneys, and nerves. In recent decades, treatment has improved with better insulin regimens and technologies such as insulin pumps, continuous glucose monitors, and hybrid closed\u2010loop systems. These reduce complications and improve quality of life. Yet challenges remain, including high DKA rates at diagnosis\u2014especially in young children and ethnic minorities, and high diabetic retinopathy rates that can impact vision. Early, tight glucose control reduces long\u2010term risks, but people with T1D still face a higher risk of early death.<\/jats:p>\n                      <\/jats:sec>\n                      <jats:sec>\n                        <jats:title>Future Research Directions<\/jats:title>\n                        <jats:p>Major research gaps remain, especially in low\u2010 and middle\u2010income countries. Data on early\u2010stage and adult\u2010onset T1D is limited but improving. As new therapies emerge, like teplizumab which is used to delay progression to stage 3, disease patterns may shift. Long\u2010term data from modern technologies is still developing, with linked administrative data offering a promising solution.<\/jats:p>\n                      <\/jats:sec>\n                      <jats:sec>\n                        <jats:title>Conclusion<\/jats:title>\n                        <jats:p>T1D is rising globally and still carries serious health risks. Understanding who is affected, when, and how the disease progresses is essential to improving prevention, care, and outcomes.<\/jats:p>\n                      <\/jats:sec>\n                    <\/jats:sec>\n                  <\/jats:sec>","DOI":"10.1111\/dom.16501","type":"journal-article","created":{"date-parts":[[2025,6,19]],"date-time":"2025-06-19T06:54:20Z","timestamp":1750316060000},"page":"3-14","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":58,"title":["The Changing Epidemiology of Type 1 Diabetes: A Global Perspective"],"prefix":"10.1111","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5638-4048","authenticated-orcid":false,"given":"Kirstine J.","family":"Bell","sequence":"first","affiliation":[{"name":"Charles Perkins Centre University of Sydney  Sydney Australia"},{"name":"Children's Hospital at Westmead Clinical School, Faculty of Medicine and Health The University of Sydney  Sydney 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