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There are entire articles written around the problem of why the prevalence of type 1 diabetes has risen - nutrition? toxins? - that don't even consider whether it might be because fewer patients are dying young & continue to be in the numerator. This should be step 1

I understand why more people with type 1 diabetes would survive today compared to 1920, but have there been great strides in diabetes treatment since, say, 1980? I know very little about this

Yeah, though the papers I'm describing are more about the historical trend. To your question, there are longer lasting release methods, some disease modifying drugs that reduce the autoimmune attack, some hormones and GLP1s used as add-ons