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

Phillip, Moshe ; Achenbach, Peter ; Addala, Ananta ; Albanese-O'Neill, Anastasia ; Battelino, Tadej ; Bell, Kirstine J ; Besser, Rachel E J ; Bonifacio, Ezio ; Colhoun, Helen M and Couper, Jennifer J , et al. (2024) In 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... (More)

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.

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organization
publishing date
type
Contribution to journal
publication status
epub
subject
in
Diabetologia
publisher
Springer
external identifiers
  • scopus:85196648312
  • pmid:38910151
ISSN
1432-0428
DOI
10.1007/s00125-024-06205-5
language
English
LU publication?
yes
additional info
© 2024. American Diabetes Association and European Association for the Study of Diabetes.
id
27583c70-0377-4959-87d2-99a92e69bfd0
date added to LUP
2024-06-28 09:29:13
date last changed
2024-07-01 08:04:52
@article{27583c70-0377-4959-87d2-99a92e69bfd0,
  abstract     = {{<p>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.</p>}},
  author       = {{Phillip, Moshe and Achenbach, Peter and Addala, Ananta and Albanese-O'Neill, Anastasia and Battelino, Tadej and Bell, Kirstine J and Besser, Rachel E J and Bonifacio, Ezio and Colhoun, Helen M and Couper, Jennifer J and Craig, Maria E and Danne, Thomas and de Beaufort, Carine and Dovc, Klemen and Driscoll, Kimberly A and Dutta, Sanjoy and Ebekozien, Osagie and Larsson, Helena Elding and Feiten, Daniel J and Frohnert, Brigitte I and Gabbay, Robert A and Gallagher, Mary P and Greenbaum, Carla J and Griffin, Kurt J and Hagopian, William and Haller, Michael J and Hendrieckx, Christel and Hendriks, Emile and Holt, Richard I G and Hughes, Lucille and Ismail, Heba M and Jacobsen, Laura M and Johnson, Suzanne B and Kolb, Leslie E and Kordonouri, Olga and Lange, Karin and Lash, Robert W and Lernmark, Åke and Libman, Ingrid and Lundgren, Markus and Maahs, David M and Marcovecchio, M Loredana and Mathieu, Chantal and Miller, Kellee M and O'Donnell, Holly K and Oron, Tal and Patil, Shivajirao P and Pop-Busui, Rodica and Rewers, Marian J and Rich, Stephen S and Schatz, Desmond A and Schulman-Rosenbaum, Rifka and Simmons, Kimber M and Sims, Emily K and Skyler, Jay S and Smith, Laura B and Speake, Cate and Steck, Andrea K and Thomas, Nicholas P B and Tonyushkina, Ksenia N and Veijola, Riitta and Wentworth, John M and Wherrett, Diane K and Wood, Jamie R and Ziegler, Anette-Gabriele and DiMeglio, Linda A}},
  issn         = {{1432-0428}},
  language     = {{eng}},
  month        = {{06}},
  publisher    = {{Springer}},
  series       = {{Diabetologia}},
  title        = {{Consensus guidance for monitoring individuals with islet autoantibody-positive pre-stage 3 type 1 diabetes}},
  url          = {{http://dx.doi.org/10.1007/s00125-024-06205-5}},
  doi          = {{10.1007/s00125-024-06205-5}},
  year         = {{2024}},
}