Consensus guidance for monitoring individuals with islet autoantibody-positive pre-stage 3 type 1 diabetes

Phillip, M; Achenbach, P; Addala, A; Albanese-O&#39;Neill, A; Battelino, T; Bell, KJ; Besser, REJ; Bonifacio, E; Colhoun, HM; Couper, JJ; Craig, ME; Danne, T; de Beaufort, C; Dovc, K; Driscoll, KA; Dutta, S; Ebekozien, O; Larsson, HE; Feiten, DJ; Frohnert, BI; Gabbay, RA; Gallagher, MP; Greenbaum, CJ; Griffin, KJ; HAGOPIAN, W; Haller, MJ; Hendrieckx, C; Hendriks, E; Holt, RIG; Hughes, L; Ismail, HM; Jacobsen, LM; Johnson, SB; Kolb, LE; Kordonouri, O; Lange, K; Lash, RW; Lernmark, &#197;; Libman, I; Lundgren, M; Maahs, DM; Marcovecchio, ML; Mathieu, C; Miller, KM; O&#39;Donnell, HK; Oron, T; Patil, SP; Pop-Busui, R; Rewers, MJ; Rich, SS; Schatz, DA; Schulman-Rosenbaum, R; Simmons, KM; Sims, EK; Skyler, JS; Smith, LB; Speake, C; Steck, AK; Thomas, NPB; Tonyushkina, KN; Veijola, R; Wentworth, JM; Wherrett, DK; Wood, JR; ZIEGLER, AG; DiMeglio, LA

Author(s): Phillip, M; Achenbach, P; Addala, A; Albanese-O'Neill, A; Battelino, T; Bell, KJ; Besser, REJ; Bonifacio, E; Colhoun, HM; Couper, JJ; Craig, ME; Danne, T; de Beaufort, C; Dovc, K; Driscoll, KA; Dutta, S; Ebekozien, O; Larsson, HE; Feiten, DJ; Frohnert, BI; Gabbay, RA; Gallagher, MP; Greenbaum, CJ; Griffin, KJ; HAGOPIAN, W; Haller, MJ; Hendrieckx, C; Hendriks, E; Holt, RIG; Hughes, L; Ismail, HM; Jacobsen, LM; Johnson, SB; Kolb, LE; Kordonouri, O; Lange, K; Lash, RW; Lernmark, Å; Libman, I; Lundgren, M; Maahs, DM; Marcovecchio, ML; Mathieu, C; Miller, KM; O'Donnell, HK; Oron, T; Patil, SP; Pop-Busui, R; Rewers, MJ; Rich, SS; Schatz, DA; Schulman-Rosenbaum, R; Simmons, KM; Sims, EK; Skyler, JS; Smith, LB; Speake, C; Steck, AK; Thomas, NPB; Tonyushkina, KN; Veijola, R; Wentworth, JM; Wherrett, DK; Wood, JR; ZIEGLER, AG; DiMeglio, LA;
Details: Publication Year 2024-09,Volume 67,Issue #9,Page 1731-1759
Journal Title: Diabetologia
Abstract: Given the proven benefits of screening to reduce diabetic ketoacidosis (DKA) likelihood at the time of stage 3 type 1 diabetes diagnosis, and emerging availability of therapy to delay disease progression, type 1 diabetes screening programmes are being increasingly emphasised. Once broadly implemented, screening initiatives will identify significant numbers of islet autoantibody-positive (IAb(+)) children and adults who are at risk of (confirmed single IAb(+)) or living with (multiple IAb(+)) early-stage (stage 1 and stage 2) type 1 diabetes. These individuals will need monitoring for disease progression; much of this care will happen in non-specialised settings. To inform this monitoring, JDRF in conjunction with international experts and societies developed consensus guidance. Broad advice from this guidance includes the following: (1) partnerships should be fostered between endocrinologists and primary-care providers to care for people who are IAb(+); (2) when people who are IAb(+) are initially identified there is a need for confirmation using a second sample; (3) single IAb(+) individuals are at lower risk of progression than multiple IAb(+) individuals; (4) individuals with early-stage type 1 diabetes should have periodic medical monitoring, including regular assessments of glucose levels, regular education about symptoms of diabetes and DKA, and psychosocial support; (5) interested people with stage 2 type 1 diabetes should be offered trial participation or approved therapies; and (6) all health professionals involved in monitoring and care of individuals with type 1 diabetes have a responsibility to provide education. The guidance also emphasises significant unmet needs for further research on early-stage type 1 diabetes to increase the rigour of future recommendations and inform clinical care.
Publisher: Springer
Keywords: Humans; *Diabetes Mellitus, Type 1/immunology/diagnosis; *Autoantibodies/immunology/blood; Consensus; Islets of Langerhans/immunology; Disease Progression; Diabetic Ketoacidosis/diagnosis/immunology; Autoantibodies; Glucose monitoring; Prevention; Type 1 diabetes
Research Division(s): Population Health And Immunity
PubMed ID: 38910151
Publisher's Version: https://doi.org/10.1007/s00125-024-06205-5
Open Access at Publisher's Site: https://doi.org/10.1007/s00125-024-06205-5
Terms of Use/Rights Notice: Refer to copyright notice on published article.

Creation Date: 2024-10-04 10:45:14

Last Modified: 2024-10-04 10:51:24