Consensus Guidance for Monitoring Individuals With Islet Autoantibody–Positive Pre-Stage 3 Type 1 Diabetes

Research output: Contribution to journalResearch articleContributedpeer-review

Contributors

  • Moshe Phillip - , Schneider Childrens Medical Center Israel, Tel Aviv University (Author)
  • Peter Achenbach - , Helmholtz Zentrum München - German Research Center for Environmental Health, Technical University of Munich (Author)
  • Ananta Addala - , Stanford University (Author)
  • Anastasia Albanese O. Neill - , Juvenile Diabetes Research Foundation (Author)
  • Tadej Battelino - , University of Ljubljana, University Medical Centre Ljubljana (Author)
  • Kirstine J. Bell - , University of Sydney (Author)
  • Rachel E.J. Besser - , University of Oxford (Author)
  • Ezio Bonifacio - , Chair of Preclinical stem cell therapy and diabetes, German Center for Diabetes Research - Paul Langerhans Insitute Dresden (Partner: HMGU) (Author)
  • Helen M. Colhoun - , University of Edinburgh, NHS Fife (Author)
  • Jennifer J. Couper - , University of Adelaide, Women's and Children's Hospital Adelaide (Author)
  • Maria E. Craig - , University of Sydney, University of New South Wales (Author)
  • Thomas Danne - , Juvenile Diabetes Research Foundation (Author)
  • Carine de Beaufort - , International Society for Pediatric and Adolescent Diabetes (ISPAD), Center Hospitalier de Luxembourg, University of Luxembourg (Author)
  • Klemen Dovc - , University of Ljubljana, University Medical Centre Ljubljana (Author)
  • Kimberly A. Driscoll - , University of Colorado Anschutz Medical Campus, University of Florida (Author)
  • Sanjoy Dutta - , Juvenile Diabetes Research Foundation (Author)
  • Osagie Ebekozien - , T1D Exchange (Author)
  • Helena Elding Larsson - , Lund University (Author)
  • Daniel J. Feiten - , Children’s Diabetes Foundation (Author)
  • Brigitte I. Frohnert - , University of Colorado Anschutz Medical Campus (Author)
  • Robert A. Gabbay - , American Diabetes Association (Author)
  • Mary P. Gallagher - , New York University (Author)
  • Carla J. Greenbaum - , Virginia Mason Medical Center (Author)
  • Kurt J. Griffin - , Sanford Health, University of South Dakota (Author)
  • William Hagopian - , University of Washington (Author)
  • Michael J. Haller - , University of Florida (Author)
  • Christel Hendrieckx - , Deakin University (Author)
  • Emile Hendriks - , University of Cambridge (Author)
  • Richard I.G. Holt - , University of Southampton, University Hospital Southampton NHS Foundation Trust (Author)
  • Lucille Hughes - , Mount Sinai South Nassau (Author)
  • Heba M. Ismail - , Indiana University-Purdue University Indianapolis (Author)
  • Laura M. Jacobsen - , University of Florida (Author)
  • Suzanne B. Johnson - , Florida State University (Author)
  • Leslie E. Kolb - , Association of Diabetes Care & Education Specialists (Author)
  • Olga Kordonouri - , Juvenile Diabetes Research Foundation (Author)
  • Karin Lange - , Hannover Medical School (MHH) (Author)
  • Robert W. Lash - , Endocrine Society (Author)
  • Åke Lernmark - , Lund University (Author)
  • Ingrid Libman - , University of Pittsburgh (Author)
  • Markus Lundgren - , Lund University, Kristianstad Hospital (Author)
  • David M. Maahs - , Stanford University (Author)
  • M. Loredana Marcovecchio - , Cambridge University Hospitals NHS Foundation Trust (Author)
  • Chantal Mathieu - , KU Leuven (Author)
  • Kellee M. Miller - , T1D Exchange (Author)
  • Holly K.O. Donnell - , University of Colorado Anschutz Medical Campus (Author)
  • Tal Oron - , Schneider Childrens Medical Center Israel, Tel Aviv University (Author)
  • Shivajirao P. Patil - , East Carolina University (Author)
  • Rodica Pop Busui - , University of Michigan, Ann Arbor (Author)
  • Marian J. Rewers - , University of Colorado Anschutz Medical Campus (Author)
  • Stephen S. Rich - , University of Virginia (Author)

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 programs are being increasingly emphasized. Once broadly implemented, screening initiatives will identify significant numbers of islet autoantibody–positive (IAb1) children and adults who are at risk for (confirmed single IAb1) or living with (multiple IAb1) 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 nonspecialized 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 IAb1; 2) when people who are IAb1 are initially identified, there is a need for confirmation using a second sample; 3) single IAb1 individuals are at lower risk of progression than multiple IAb1 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 inmonitoring and care of individualswith type 1 diabetes have a responsibility to provide education. The guidance also emphasizes significant unmet needs for further research on early-stage type 1 diabetes to increase the rigor of future recommendations and informclinical care.

Details

Original languageEnglish
Pages (from-to)1276-1298
Number of pages23
JournalDiabetes care
Volume47
Issue number8
Publication statusPublished - Aug 2024
Peer-reviewedYes

External IDs

PubMed 39240700
ORCID /0000-0002-8704-4713/work/171553157