Michael J Haller MDa Mark A Atkinson PhDb Desmond Schatz MDc

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aDivision of Pediatric Endocrinology, University of Florida College of Medicine, PO Box 100296,

Gainesville, FL 32610, USA hTke Center for Immunology and Transplantation, University of Florida College of Medicine, Room R3-128, ARB, Gainesville, FL 32610-0275, USA cDiabetes Center, University of Florida College of Medicine, PO Box 100296, Gainesville, FL 32610, USA

Type 1 diabetes mellitus (T1D) is a heterogeneous disorder characterized by autoimmune-mediated destruction of pancreatic beta cells that culminates in absolute insulin deficiency. T1D is most commonly diagnosed in children and adolescents, usually presents with symptomatic hyperglycemia, and imparts the immediate need for exogenous insulin replacement. Approximately one fourth of patients with T1D are diagnosed as adults and often are labeled as having latent autoimmune disease of adults, however. Approximately 5% to 10% of adults diagnosed with type 2 diabetes actually may have T1D. Terms such as ''juvenile diabetes'' and ''insulin-dependent diabetes'' have been replaced because they no longer adequately reflect our understanding of the natural history and patho-physiology of T1D. This article provides an in-depth review regarding our current understanding of the epidemiology, etiology, presentation, and management of T1D as it relates to childhood and adolescence.

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