Type 1 diabetes has shifted from a condition once associated with early mortality to a chronic disease owing to the development of intensive insulin therapy, continuous glucose monitoring, and hybrid closed-loop systems. Despite near-normoglycaemia becoming an attainable target, residual excess mortality and cardiovascular risk persist. These outcomes are thought to reflect the long-term biological legacy of earlier dysglycaemia, including metabolic and epigenetic memory associated with inflammatory and vascular vulnerability.
Type 1 diabetes has shifted from a condition once associated with early mortality to a chronic disease owing to the development of intensive insulin therapy, continuous glucose monitoring, and hybrid closed-loop systems. Despite near-normoglycaemia becoming an attainable target, residual excess mortality and cardiovascular risk persist. These outcomes are thought to reflect the long-term biological legacy of earlier dysglycaemia, including metabolic and epigenetic memory associated with inflammatory and vascular vulnerability.