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Fig 1.

PRISMA flow diagram of study selection.

This figure outlines the study selection process using the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) framework. The flow diagram depicts the number of records identified through database searches, screening, eligibility assessments, and final inclusion in the analysis.

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Fig 2.

Three stages of natural history of T1D.

Taken from Kawaski et al. [33] under the Creative Commons Attribution (CC BY) license.

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Fig 3.

Mechanisms of action of anti-thymocyte globulin.

A: T-cell depletion in blood through complement-mediated lysis and in secondary lymphoid tissue by T cell apoptosis; B: Beta-cell apoptosis by anti-thymocyte globulin (ATG); C: ATG-VLA-4 complex leading to decreased adhesion proteins in endothelial cells required by leukocyte/endothelium interaction; D: Dendritic cell maturation by HLA1/ATG interaction; E: Increased natural killer T cells. Taken from Acharya [62] under the Creative Commons Attribution Non-Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited.

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Table 1.

A summary of all the studies included in this systematic review.

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Fig 4.

Risk of Bias (RoB) Assessment for Randomized Clinical Trials (RCTs).

This figure illustrates the risk of bias evaluation across multiple domains for the included RCTs. Each domain is represented by a bar or chart segment, with color coding to indicate different levels of bias: green (low risk), and yellow (unclear risk).

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Fig 5.

Risk of Bias (RoB) assessment for case control series.

This figure illustrates the risk of bias evaluation across multiple domains for case control series. Each domain is represented by a bar or chart segment, with color coding to indicate different levels of bias: green (low risk), and yellow (unclear risk).

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