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

Title: Consensus guidance for monitoring individuals with islet autoantibody-positive pre-stage 3 type 1 diabetes
Authors: 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
Publisher Information: Springer
Publication Year: 2025
Collection: Oxford University Research Archive (ORA)
Description: 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. Graphical Abstract
Document Type: article in journal/newspaper
Language: English
DOI: 10.1007/s00125-024-06205-5
Availability: https://doi.org/10.1007/s00125-024-06205-5; https://ora.ox.ac.uk/objects/uuid:7d6991a7-53dc-4854-9306-741a7206179c
Rights: info:eu-repo/semantics/openAccess ; CC Attribution (CC BY)
Accession Number: edsbas.690223EA
Database: BASE