Consensus Guidance for Monitoring Individuals With Islet Autoantibody–Positive Pre-Stage 3 Type 1 Diabetes-Reference-Cited by-同舟云学术

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

Published:2024-06-24 Issue: Volume: Page:
ISSN:0149-5992
Container-title:Diabetes Care
language:en
Short-container-title:

Author:

Phillip Moshe¹²^ORCID,Achenbach Peter³⁴^ORCID,Addala Ananta⁵⁶^ORCID,Albanese-O’Neill Anastasia⁷^ORCID,Battelino Tadej⁸⁹^ORCID,Bell Kirstine J.¹⁰^ORCID,Besser Rachel E.J.¹¹¹²^ORCID,Bonifacio Ezio¹³¹⁴^ORCID,Colhoun Helen M.¹⁵¹⁶^ORCID,Couper Jennifer J.¹⁷¹⁸¹⁹^ORCID,Craig Maria E.¹⁰²⁰^ORCID,Danne Thomas²¹^ORCID,de Beaufort Carine²²²³²⁴^ORCID,Dovc Klemen⁸⁹^ORCID,Driscoll Kimberly A.²⁵²⁶²⁷^ORCID,Dutta Sanjoy²⁸^ORCID,Ebekozien Osagie²⁹^ORCID,Elding Larsson Helena³⁰³¹^ORCID,Feiten Daniel J.³²^ORCID,Frohnert Brigitte I.²⁵,Gabbay Robert A.³³^ORCID,Gallagher Mary P.³⁴^ORCID,Greenbaum Carla J.³⁵^ORCID,Griffin Kurt J.³⁶³⁷^ORCID,Hagopian William³⁸,Haller Michael J.²⁷³⁹^ORCID,Hendrieckx Christel⁴⁰⁴¹⁴²^ORCID,Hendriks Emile⁴³^ORCID,Holt Richard I.G.⁴⁴⁴⁵^ORCID,Hughes Lucille⁴⁶,Ismail Heba M.⁴⁷^ORCID,Jacobsen Laura M.³⁹^ORCID,Johnson Suzanne B.⁴⁸^ORCID,Kolb Leslie E.⁴⁹^ORCID,Kordonouri Olga²¹^ORCID,Lange Karin⁵⁰^ORCID,Lash Robert W.⁵¹^ORCID,Lernmark Åke³⁰^ORCID,Libman Ingrid⁵²^ORCID,Lundgren Markus³⁰⁵³^ORCID,Maahs David M.⁵^ORCID,Marcovecchio M. Loredana⁵⁴^ORCID,Mathieu Chantal⁵⁵^ORCID,Miller Kellee M.²⁹,O’Donnell Holly K.²⁵^ORCID,Oron Tal¹²^ORCID,Patil Shivajirao P.⁵⁶^ORCID,Pop-Busui Rodica⁵⁷^ORCID,Rewers Marian J.²⁵^ORCID,Rich Stephen S.⁵⁸^ORCID,Schatz Desmond A.⁵⁹^ORCID,Schulman-Rosenbaum Rifka⁶⁰^ORCID,Simmons Kimber M.²⁵^ORCID,Sims Emily K.⁶¹^ORCID,Skyler Jay S.⁶²^ORCID,Smith Laura B.⁶³^ORCID,Speake Cate³⁵^ORCID,Steck Andrea K.²⁵^ORCID,Thomas Nicholas P.B.⁶⁴^ORCID,Tonyushkina Ksenia N.⁶⁵^ORCID,Veijola Riitta⁶⁶^ORCID,Wentworth John M.⁶⁷⁶⁸^ORCID,Wherrett Diane K.⁶⁹^ORCID,Wood Jamie R.⁷⁰,Ziegler Anette-Gabriele³⁴^ORCID,DiMeglio Linda A.⁴⁶^ORCID

Affiliation:

1. 1Institute for Endocrinology and Diabetes, National Center for Childhood Diabetes, Schneider Children's Medical Center of Israel, Petah Tikva, Israel

2. 2Faculty of Medical and Health Sciences, Tel Aviv University, Tel Aviv, Israel

3. 3Institute of Diabetes Research, Helmholtz Zentrum München, German Research Center for Environmental Health, Munich-Neuherberg, Germany

4. 4Forschergruppe Diabetes, Technical University Munich, Klinikum Rechts Der Isar, Munich, Germany

5. 5Division of Endocrinology, Department of Pediatrics, Stanford University School of Medicine, Stanford, CA

6. 6Stanford Diabetes Research Center, Stanford University School of Medicine, Stanford, CA

7. 7Breakthrough T1D, Gainesville, FL

8. 8Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia

9. 9Department of Endocrinology, Diabetes and Metabolism, University Medical Centre Ljubljana, Ljubljana, Slovenia

10. 10Charles Perkins Centre and Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia

11. 11JDRF/Wellcome Diabetes and Inflammation Laboratory, Wellcome Centre Human Genetics, Nuffield Department of Medicine Oxford National Institute for Health and Care Research Biomedical Research Centre, University of Oxford, Oxford, U.K.

12. 12Department of Paediatrics, University of Oxford, Oxford, U.K.

13. 13Center for Regenerative Therapies Dresden, Faculty of Medicine, Technical University of Dresden, Dresden, Germany

14. 14Paul Langerhans Institute Dresden, Helmholtz Centre Munich at the University Clinic Carl Gustav Carus of Technical University of Dresden, and Faculty of Medicine, Technical University of Dresden, Dresden, Germany

15. 15The Institute of Genetics and Cancer, University of Edinburgh, Edinburgh, U.K.

16. 16Department of Public Health, NHS Fife, Kirkcaldy, U.K.

17. 17Robinson Research Institute, The University of Adelaide, Adelaide, South Australia, Australia

18. 18Adelaide Medical School, The University of Adelaide, Adelaide, South Australia, Australia

19. 19Division of Paediatrics, Women’s and Children’s Hospital, Adelaide, South Australia, Australia

20. 20Discipline of Paediatrics & Child Health, School of Clinical Medicine, UNSW Medicine & Health, Sydney, New South Wales, Australia

21. 21Breakthrough T1D, Lisbon

22. 22International Society for Pediatric and Adolescent Diabetes (ISPAD), Berlin, Germany

23. 23Diabetes & Endocrine Care Clinique Pédiatrique (DECCP), Clinique Pédiatrique/Centre Hospitalier (CH) de Luxembourg, Luxembourg City, Luxembourg

24. 24Faculty of Science, Technology and Medicine, University of Luxembourg, Esch-Belval, Luxembourg

25. 25Department of Pediatrics, Barbara Davis Center for Diabetes, University of Colorado Anschutz Medical Campus, Aurora, CO

26. 26Department of Clinical and Health Psychology, University of Florida, Gainesville, FL

27. 27Department of Pediatrics, University of Florida Diabetes Institute, Gainesville, FL

28. 28Breakthrough T1D, New York, NY

29. 29T1D Exchange, Boston, MA

30. 30Department of Clinical Sciences, Malmö, Lund University, Lund, Sweden

31. 31Department of Pediatrics, Skåne University Hospital, Malmö and Lund, Sweden

32. 32Children’s Diabetes Foundation, Aurora, CO

33. 33American Diabetes Association, Arlington, VA

34. 34NYU Langone Medical Center, New York, NY

35. 35Center for Interventional Immunology and Diabetes Program, Benaroya Research Institute, Seattle, WA

36. 36Sanford Research, Sioux Falls, SD

37. 37Department of Pediatrics, Sanford School of Medicine, University of South Dakota, Sioux Falls, SD

38. 38Pacific Northwest Diabetes Research Institute, University of Washington, Seattle, WA

39. 39Division of Endocrinology, University of Florida College of Medicine, Gainesville, FL

40. 40School of Psychology, Deakin University, Geelong, Victoria, Australia

41. 41The Australian Centre for Behavioural Research in Diabetes, Diabetes Victoria, Carlton, Victoria, Australia

42. 42Institute for Health Transformation, Deakin University, Geelong, Victoria, Australia

43. 43Department of Paediatrics, University of Cambridge and Cambridge University Hospitals NHS Foundation Trust, Cambridge, U.K.

44. 44Human Development and Health, Faculty of Medicine, University of Southampton, Southampton, U.K.

45. 45National Institute for Health and Care Research Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, U.K.

46. 46Mount Sinai South Nassau, Oceanside, NY

47. 47Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN

48. 48Department of Behavioral Sciences and Social Medicine, Florida State University College of Medicine, Tallahassee, FL

49. 49Association of Diabetes Care & Education Specialists, Chicago, IL

50. 50Medical Psychology, Hannover Medical School, Hannover, Germany

51. 51Endocrine Society, Washington, DC

52. 52Division of Pediatric Endocrinology and Diabetes, University of Pittsburgh, University of Pittsburgh Medical Center Children's Hospital of Pittsburgh, PA

53. 53Department of Pediatrics, Kristianstad Hospital, Kristianstad, Sweden

54. 54Department of Pediatrics, Cambridge University Hospitals NHS Foundation Trust, Cambridge, U.K.

55. 55Department of Endocrinology, UZ Gasthuisberg, KU Leuven, Leuven, Belgium

56. 56Department of Family Medicine, Brody School of Medicine, East Carolina University, Greenville, NC

57. 57Department of Internal Medicine, Division of Metabolism, Endocrinology and Diabetes, University of Michigan, Ann Arbor, MI

58. 58Center for Public Health Genomics, University of Virginia, Charlottesville, VA

59. 59Department of Pediatrics, University of Florida, Gainesville, FL

60. 60Division of Endocrinology, Long Island Jewish Medical Center, Northwell Health, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, New Hyde Park, NY

61. 61Division of Pediatric Endocrinology and Diabetology, Herman B Wells Center for Pediatric Research, Center for Diabetes and Metabolic Diseases, Indiana University School of Medicine, Indianapolis, IN

62. 62Diabetes Research Institute, University of Miami Miller School of Medicine, Miami, FL

63. 63Cincinnati Children’s Hospital Medical Center, Cincinnati, OH

64. 64National Institute of Health and Care Research Clinical Research Network Thames Valley and South Midlands, Oxford, U.K.

65. 65Division of Endocrinology and Diabetes, Baystate Children’s Hospital and University of Massachusetts Chan Medical School–Baystate, Springfield, MA

66. 66Research Unit of Clinical Medicine, Department of Pediatrics, Medical Research Center, Oulu University Hospital and University of Oulu, Oulu, Finland

67. 67The Walter and Eliza Hall Institute of Medical Research, Parkville, Victoria, Australia

68. 68Department of Diabetes and Endocrinology, Royal Melbourne Hospital, Parkville, Victoria, Australia

69. 69Department of Paediatrics, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada

70. 70Department of Pediatric Endocrinology, Rainbow Babies and Children's Hospital, University Hospitals Cleveland Medical Center, Cleveland, OH

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 (IAb+) children and adults who are at risk for (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 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 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 emphasizes significant unmet needs for further research on early-stage type 1 diabetes to increase the rigor of future recommendations and inform clinical care.

Publisher

American Diabetes Association

Link

https://diabetesjournals.org/care/article-pdf/doi/10.2337/dci24-0042/774950/dci240042.pdf

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