Type 1 diabetes (T1D) is widely considered to result from the autoimmune destruction of insulin-producing β-cells. This concept has been a central tenet for decades of attempts seeking to decipher the disorder’s pathogenesis and prevent/reverse the disease. Recently, this and many other disease-related notions have come under increasing question, particularly given knowledge gains from analyses, using newly arising technologies, of human T1D pancreas. Perhaps most crucial are findings suggesting that a collective of cellular constituents — immune, endocrine, and exocrine in origin — mechanistically coalesce to facilitate T1D. This lecture will convey these emerging concepts, from basic science to clinical research, note several key remaining knowledge voids, and share how such information will lead to the next generation of medical advances for T1D.

Dr. Mark Atkinson is currently the American Diabetes Association Eminent Scholar for Diabetes Research at the University of Florida (UF), the Jeffrey Keene Family Professor, and the Director for the UF Diabetes Institute. The author of over 600 publications, 2023 marked his 40th year of investigation into the field of type 1 diabetes (T1D). Expertscape notes him to be among the top three most cited authors in T1D, at a global level, over the last two decades. His research interests include the pathogenesis and natural history of T1D, immune regulation, disease biomarkers, clinical trials for T1D prevention/reversal, and pancreatic pathology. Dr. Atkinson has also been active in a leadership service to the T1D community, with active administrative or advisory service with JDRF, the American Diabetes Association, The National Institutes of Health, the Immunology of Diabetes Society, and more. He has served as the ad Hoc Editor in Chief of the journals Diabetes and Diabetes Care for more than a decade, is a Steering Committee Member of the NIH Immune Tolerance Network (22 years), and a member of NIH TrialNet. Through his founding leadership of an effort known as nPOD, he directs what is among the world’s largest T1D research effort (over 300 projects in 21 countries). Finally, Dr. Atkinson is active at a global level for causes related to the care and treatment of those in the third world; especially and including persons with T1D. For this cause, he serves as President of Insulin for Life USA and is an Advisor to Life for a Child. Dr. Atkinson has been the recipient of numerous scientific and humanitarian-based awards for these academic and charitable efforts.