Interception, Preservation, and Cure Pathways in Type 1 Diabetes: Advances in Pediatric Research

Type 1 diabetes research in children is rapidly evolving from symptomatic insulin replacement toward early interception, beta cell preservation, and disease-modifying treatment. Although staging systems and improved screening have clarified the progression from genetic susceptibility and islet autoimmunity to clinical disease, substantial questions remain regarding why progression rates differ between children, how environmental and developmental factors shape disease trajectories, and how atypical or autoantibody-negative presentations should be classified. Clinical studies have demonstrated that immunomodulatory treatment can delay progression in selected at-risk individuals, while investigations in newly diagnosed children suggest that early intervention may preserve residual beta cell function. Advances in stem cell-derived beta cells, encapsulation, cellular immunotherapy, multi-omics, and artificial intelligence are further expanding therapeutic possibilities. However, challenges remain in achieving durable remission, addressing treatment heterogeneity, defining pediatric-specific risks, validating combination therapies, and ensuring equitable access to screening and emerging interventions. A coordinated Research Topic is therefore needed to integrate mechanistic, clinical, translational, technological, and global perspectives on the future of pediatric type 1 diabetes.This Research Topic aims to examine strategies that prevent or delay the development of type 1 diabetes, preserve endogenous insulin secretion after diagnosis, and advance durable remission or insulin independence in children. It will explore how immunological, metabolic, genetic, developmental, and environmental factors influence disease onset and treatment response. Contributions may address the efficacy, safety, feasibility, and ethical implications of early intervention; the development of personalized risk prediction and treatment algorithms; and the integration of immunomodulation with beta cell regeneration or replacement. The Research Topic also seeks to evaluate emerging theories of disease heterogeneity, including presentations without high-risk HLA genotypes, autoantibody-negative diabetes, hybrid phenotypes, and novel environmental or mechanistic triggers.To gather further insights in pediatric type 1 diabetes prevention, treatment, and potential remission, this Research Topic will focus on studies involving children and adolescents at risk for, newly diagnosed with, or living with type 1 diabetes, while recognizing relevant translational and implementation research. We welcome articles addressing, but not limited to, the following themes:• Early interception of autoimmunity and prevention of progression across stages 1, 2, and 3• Preservation of beta cell function and reduction of beta cell stress after diagnosis• Cellular, molecular, genetic, and nanotechnology-based immunomodulatory therapies• Stem cell-derived beta cells, organoids, encapsulation, and in vivo cellular reprogramming• Combination strategies integrating immunotherapy, metabolic modulation, and beta cell replacement• Precision medicine, multi-omics, artificial intelligence, digital twins, and predictive modeling• Pediatric-specific immunology, developmental influences, puberty, and disease trajectories• Atypical, hybrid, and autoantibody-negative presentations of pediatric diabetes• Screening programs, implementation science, health equity, and global access to emerging therapies• Ethical considerations in early-stage intervention trials and pediatric regenerative medicineThe Research Topic welcomes original research, clinical trial reports, translational studies, reviews, and perspectives. Topic editors: MARCELO MAIA PINHEIRO, Benjamin Udoka Nwosu, Marco Infante Source: https://www.frontiersin.org/research-topics/82306/interception-preservation-and-cure-pathways-in-type-1-diabetes-advances-in-pediatric-research