For decades, type 1 diabetes has been viewed almost exclusively through an immunological lens, with insulin regarded as the sole pillar of survival. While insulin remains the cornerstone of therapy, advances in diabetes research are challenging the traditional “insulin-only” approach by exploring therapies that target additional metabolic pathways.
In this Journal Club, we will examine the emerging role of adjunctive therapies in type 1 diabetes, including GLP-1 receptor agonists, SGLT inhibitors and other novel interventions that may improve glycaemic control, reduce insulin requirements and support weight management. We will also explore the concept of beta-cell metabolic fitness, where preserving remaining beta-cell function may represent an important therapeutic goal alongside glucose management.
As our understanding of type 1 diabetes continues to evolve, this discussion invites us to reconsider whether management should focus solely on replacing insulin or embrace a broader strategy aimed at stabilising metabolism, preserving physiology and improving long-term patient outcomes.
Host
Dr Stan Landau
CDE Academy Journal Club Host
Guest Expert
Professor Joel Dave
Head of the Division of Endocrinology | University of Cape Town
Speaker Bio
Professor Joel Dave has served as Head of the Division of Endocrinology at the University of Cape Town since September 2018. He obtained his MBChB from UCT in 1991, completed a PhD in 2000 investigating proteases from Mycobacterium tuberculosis, and subsequently qualified as a specialist in Internal Medicine before completing subspecialist training in Endocrinology in 2006.
Following seven years in private practice, during which he remained actively involved in clinical research, undergraduate and postgraduate teaching, and specialist endocrine clinics, Professor Dave returned to full-time academic medicine in 2016. His research interests include the metabolic complications of HIV infection and antiretroviral therapy, together with a broad range of endocrine disorders.
Professor Dave has published extensively in international journals, supervises Master’s and PhD students, has served on numerous national and international pharmaceutical advisory boards, and has played a leading role in the development of South African clinical guidelines, including those relating to type 2 diabetes, insulin pump therapy and thyroid disease. He is a past Chairperson of both the Society for Endocrinology, Metabolism and Diabetes of South Africa (SEMDSA) and the Association of Clinical Endocrinologists of South Africa (ACE-SA).
