Clinical care advice for monitoring of islet autoantibody positive individuals with presymptomatic type 1 diabetes
Background/Aim Type 1 diabetes is an autoimmune disease that involves the development of autoantibodies against pancreatic islet beta‐cell antigens, preceding clinical diagnosis by a period of preclinical disease activity. As screening activity to identify autoantibody‐positive individuals increases...
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| Vydáno v: | Diabetes/metabolism research and reviews Ročník 40; číslo 2; s. e3777 - n/a |
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| Médium: | Journal Article |
| Jazyk: | angličtina |
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England
Wiley Subscription Services, Inc
01.02.2024
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| ISSN: | 1520-7552, 1520-7560, 1520-7560 |
| On-line přístup: | Získat plný text |
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| Abstract | Background/Aim
Type 1 diabetes is an autoimmune disease that involves the development of autoantibodies against pancreatic islet beta‐cell antigens, preceding clinical diagnosis by a period of preclinical disease activity. As screening activity to identify autoantibody‐positive individuals increases, a rise in presymptomatic type 1 diabetes individuals seeking medical attention is expected. Current guidance on how to monitor these individuals in a safe but minimally invasive way is limited. This article aims to provide clinical guidance for monitoring individuals with presymptomatic type 1 diabetes to reduce the risk of diabetic ketoacidosis (DKA) at diagnosis.
Methods
Expert consensus was obtained from members of the Fr1da, GPPAD, and INNODIA consortia, three European diabetes research groups. The guidance covers both specialist and primary care follow‐up strategies.
Results
The guidance outlines recommended monitoring approaches based on age, disease stage and clinical setting. Individuals with presymptomatic type 1 diabetes are best followed up in specialist care. For stage 1, biannual assessments of random plasma glucose and HbA1c are suggested for children, while annual assessments are recommended for adolescents and adults. For stage 2, 3‐monthly clinic visits with additional home monitoring are advised. The value of repeat OGTT in stage 1 and the use of continuous glucose monitoring in stage 2 are discussed. Primary care is encouraged to monitor individuals who decline specialist care, following the guidance presented.
Conclusions
As type 1 diabetes screening programs become more prevalent, effective monitoring strategies are essential to mitigate the risk of complications such as DKA. This guidance serves as a valuable resource for clinicians, providing practical recommendations tailored to an individual's age and disease stage, both within specialist and primary care settings. |
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| AbstractList | Type 1 diabetes is an autoimmune disease that involves the development of autoantibodies against pancreatic islet beta-cell antigens, preceding clinical diagnosis by a period of preclinical disease activity. As screening activity to identify autoantibody-positive individuals increases, a rise in presymptomatic type 1 diabetes individuals seeking medical attention is expected. Current guidance on how to monitor these individuals in a safe but minimally invasive way is limited. This article aims to provide clinical guidance for monitoring individuals with presymptomatic type 1 diabetes to reduce the risk of diabetic ketoacidosis (DKA) at diagnosis.
Expert consensus was obtained from members of the Fr1da, GPPAD, and INNODIA consortia, three European diabetes research groups. The guidance covers both specialist and primary care follow-up strategies.
The guidance outlines recommended monitoring approaches based on age, disease stage and clinical setting. Individuals with presymptomatic type 1 diabetes are best followed up in specialist care. For stage 1, biannual assessments of random plasma glucose and HbA1c are suggested for children, while annual assessments are recommended for adolescents and adults. For stage 2, 3-monthly clinic visits with additional home monitoring are advised. The value of repeat OGTT in stage 1 and the use of continuous glucose monitoring in stage 2 are discussed. Primary care is encouraged to monitor individuals who decline specialist care, following the guidance presented.
As type 1 diabetes screening programs become more prevalent, effective monitoring strategies are essential to mitigate the risk of complications such as DKA. This guidance serves as a valuable resource for clinicians, providing practical recommendations tailored to an individual's age and disease stage, both within specialist and primary care settings. Type 1 diabetes is an autoimmune disease that involves the development of autoantibodies against pancreatic islet beta-cell antigens, preceding clinical diagnosis by a period of preclinical disease activity. As screening activity to identify autoantibody-positive individuals increases, a rise in presymptomatic type 1 diabetes individuals seeking medical attention is expected. Current guidance on how to monitor these individuals in a safe but minimally invasive way is limited. This article aims to provide clinical guidance for monitoring individuals with presymptomatic type 1 diabetes to reduce the risk of diabetic ketoacidosis (DKA) at diagnosis.BACKGROUND/AIMType 1 diabetes is an autoimmune disease that involves the development of autoantibodies against pancreatic islet beta-cell antigens, preceding clinical diagnosis by a period of preclinical disease activity. As screening activity to identify autoantibody-positive individuals increases, a rise in presymptomatic type 1 diabetes individuals seeking medical attention is expected. Current guidance on how to monitor these individuals in a safe but minimally invasive way is limited. This article aims to provide clinical guidance for monitoring individuals with presymptomatic type 1 diabetes to reduce the risk of diabetic ketoacidosis (DKA) at diagnosis.Expert consensus was obtained from members of the Fr1da, GPPAD, and INNODIA consortia, three European diabetes research groups. The guidance covers both specialist and primary care follow-up strategies.METHODSExpert consensus was obtained from members of the Fr1da, GPPAD, and INNODIA consortia, three European diabetes research groups. The guidance covers both specialist and primary care follow-up strategies.The guidance outlines recommended monitoring approaches based on age, disease stage and clinical setting. Individuals with presymptomatic type 1 diabetes are best followed up in specialist care. For stage 1, biannual assessments of random plasma glucose and HbA1c are suggested for children, while annual assessments are recommended for adolescents and adults. For stage 2, 3-monthly clinic visits with additional home monitoring are advised. The value of repeat OGTT in stage 1 and the use of continuous glucose monitoring in stage 2 are discussed. Primary care is encouraged to monitor individuals who decline specialist care, following the guidance presented.RESULTSThe guidance outlines recommended monitoring approaches based on age, disease stage and clinical setting. Individuals with presymptomatic type 1 diabetes are best followed up in specialist care. For stage 1, biannual assessments of random plasma glucose and HbA1c are suggested for children, while annual assessments are recommended for adolescents and adults. For stage 2, 3-monthly clinic visits with additional home monitoring are advised. The value of repeat OGTT in stage 1 and the use of continuous glucose monitoring in stage 2 are discussed. Primary care is encouraged to monitor individuals who decline specialist care, following the guidance presented.As type 1 diabetes screening programs become more prevalent, effective monitoring strategies are essential to mitigate the risk of complications such as DKA. This guidance serves as a valuable resource for clinicians, providing practical recommendations tailored to an individual's age and disease stage, both within specialist and primary care settings.CONCLUSIONSAs type 1 diabetes screening programs become more prevalent, effective monitoring strategies are essential to mitigate the risk of complications such as DKA. This guidance serves as a valuable resource for clinicians, providing practical recommendations tailored to an individual's age and disease stage, both within specialist and primary care settings. Background/AimType 1 diabetes is an autoimmune disease that involves the development of autoantibodies against pancreatic islet beta‐cell antigens, preceding clinical diagnosis by a period of preclinical disease activity. As screening activity to identify autoantibody‐positive individuals increases, a rise in presymptomatic type 1 diabetes individuals seeking medical attention is expected. Current guidance on how to monitor these individuals in a safe but minimally invasive way is limited. This article aims to provide clinical guidance for monitoring individuals with presymptomatic type 1 diabetes to reduce the risk of diabetic ketoacidosis (DKA) at diagnosis.MethodsExpert consensus was obtained from members of the Fr1da, GPPAD, and INNODIA consortia, three European diabetes research groups. The guidance covers both specialist and primary care follow‐up strategies.ResultsThe guidance outlines recommended monitoring approaches based on age, disease stage and clinical setting. Individuals with presymptomatic type 1 diabetes are best followed up in specialist care. For stage 1, biannual assessments of random plasma glucose and HbA1c are suggested for children, while annual assessments are recommended for adolescents and adults. For stage 2, 3‐monthly clinic visits with additional home monitoring are advised. The value of repeat OGTT in stage 1 and the use of continuous glucose monitoring in stage 2 are discussed. Primary care is encouraged to monitor individuals who decline specialist care, following the guidance presented.ConclusionsAs type 1 diabetes screening programs become more prevalent, effective monitoring strategies are essential to mitigate the risk of complications such as DKA. This guidance serves as a valuable resource for clinicians, providing practical recommendations tailored to an individual's age and disease stage, both within specialist and primary care settings. Background/Aim: Type 1 diabetes is an autoimmune disease that involves the development of autoantibodies against pancreatic islet beta-cell antigens, preceding clinical diagnosis by a period of preclinical disease activity. As screening activity to identify autoantibody-positive individuals increases, a rise in presymptomatic type 1 diabetes individuals seeking medical attention is expected. Current guidance on how to monitor these individuals in a safe but minimally invasive way is limited. This article aims to provide clinical guidance for monitoring individuals with presymptomatic type 1 diabetes to reduce the risk of diabetic ketoacidosis (DKA) at diagnosis. Methods: Expert consensus was obtained from members of the Fr1da, GPPAD, and INNODIA consortia, three European diabetes research groups. The guidance covers both specialist and primary care follow-up strategies. Results: The guidance outlines recommended monitoring approaches based on age, disease stage and clinical setting. Individuals with presymptomatic type 1 diabetes are best followed up in specialist care. For stage 1, biannual assessments of random plasma glucose and HbA1c are suggested for children, while annual assessments are recommended for adolescents and adults. For stage 2, 3-monthly clinic visits with additional home monitoring are advised. The value of repeat OGTT in stage 1 and the use of continuous glucose monitoring in stage 2 are discussed. Primary care is encouraged to monitor individuals who decline specialist care, following the guidance presented. Conclusions: As type 1 diabetes screening programs become more prevalent, effective monitoring strategies are essential to mitigate the risk of complications such as DKA. This guidance serves as a valuable resource for clinicians, providing practical recommendations tailored to an individual's age and disease stage, both within specialist and primary care settings. Background/Aim Type 1 diabetes is an autoimmune disease that involves the development of autoantibodies against pancreatic islet beta‐cell antigens, preceding clinical diagnosis by a period of preclinical disease activity. As screening activity to identify autoantibody‐positive individuals increases, a rise in presymptomatic type 1 diabetes individuals seeking medical attention is expected. Current guidance on how to monitor these individuals in a safe but minimally invasive way is limited. This article aims to provide clinical guidance for monitoring individuals with presymptomatic type 1 diabetes to reduce the risk of diabetic ketoacidosis (DKA) at diagnosis. Methods Expert consensus was obtained from members of the Fr1da, GPPAD, and INNODIA consortia, three European diabetes research groups. The guidance covers both specialist and primary care follow‐up strategies. Results The guidance outlines recommended monitoring approaches based on age, disease stage and clinical setting. Individuals with presymptomatic type 1 diabetes are best followed up in specialist care. For stage 1, biannual assessments of random plasma glucose and HbA1c are suggested for children, while annual assessments are recommended for adolescents and adults. For stage 2, 3‐monthly clinic visits with additional home monitoring are advised. The value of repeat OGTT in stage 1 and the use of continuous glucose monitoring in stage 2 are discussed. Primary care is encouraged to monitor individuals who decline specialist care, following the guidance presented. Conclusions As type 1 diabetes screening programs become more prevalent, effective monitoring strategies are essential to mitigate the risk of complications such as DKA. This guidance serves as a valuable resource for clinicians, providing practical recommendations tailored to an individual's age and disease stage, both within specialist and primary care settings. |
| Author | Elding Larsson, Helena Costecalde, G. Hendriks, A. E. J. Szypowska, Agnieszka Dayan, C. Scharfmann, R. Richardson, S. Nikolic, T. Solimena, M. Lundgren, Markus Goldfine, A. Veijola, R. Cnop, M. Krogvold, L. Rampelbergh, J. Gillard, P. Vela, J. Latres, E. Johannesen, J. Strube, T. Casteels, K. Schulte, A. Bruggraber, S. Ziegler, Anette G. Toppari, J. Pieber, T. Speier, S. Hendriks, A. Emile J. Herrath, M. Beaufort, C. Kordonouri, Olga Skrivarhaug, T. Dunger, D. Wicker, L. Legido Quigley, C. Oresic, M. Nitsche, A. Peakman, M. Joner, G. Mallone, Roberto Marchetti, P. Thomas, M. Ciampalini, P. Gemulla, Gita Bonifacio, E. Alhadj Ali, M. Overbergh, L. Danne, T. Boitard, C. Besser, Rachel E. J. Evans, M. Waldron‐Lynch, F. Bonifacio, Ezio Todd, J. Ahmed, S. Pociot, F. Nicolas, G. Lahesmaa, R. Wesley, J. Agiostratidou, G. Marcovecchio, M. L. Holl, R. Pociot, Flemming Knip, M. Casteels, Kristina Berge, Thekla von dem Otonkoski, T. Ziegler, A. G. Vedala, A. Mathieu, C. Thankamony, A. Chiarelli, F. Dahl‐Jørgensen, K. Brunak, S. Battelino, T. Wallace, C. Cianfarani, S. Topp |
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| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/38375753$$D View this record in MEDLINE/PubMed |
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| ContentType | Journal Article |
| Contributor | Ciampalini, P Vela, J Danne, T Overbergh, L Thankamony, A Knip, M Nicolas, G Martin, F Veijola, R Bovy, N Dunger, D Dayan, C Dotta, F Costecalde, G Joner, G Marcovecchio, M L Battelino, T Gillard, P Johannesen, J Pociot, F Bosi, E Mallone, R Schloot, N Speier, S Wesley, J Agiostratidou, G von Herrath, M Boitard, C Latres, E Tree, T Lernmark, A Cianfarani, S Lundgren, M Waldron-Lynch, F Bonifacio, E Todd, J de Beaufort, C Zaldumbide, A Strube, T van Rampelbergh, J Otonkoski, T Oresic, M Soderberg, J Dutta, S Solimena, M Rossing, P Vedala, A Skrivarhaug, T Alhadj Ali, M Pieber, T Napolitano-Rosen, A Koralova, A Holl, R Casteels, K Hendriks, A E J Schulte, A Evans, M Lahesmaa, R Kompa, J Marchetti, P Scharfmann, R Chiarelli, F Toppari, J Achenbach, P Ahmed, S Mander, A Cnop, M Krogvold, L Brunak, S Goldfine, A Roep, B Richardson, S Ziegler, A G Thorens, B Wicker, L Eizirik, D Legido Quigley, C Dahl-Jørgensen, K Gotthardt, M Peakman, M Mathieu, C Rodriguez-Calvo, T Nitsche, A Jarosz-Chobot, P Bruggraber, S Thomas, M Morgan, N Wallace, C Nikolic, T Hartmann, N |
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| Copyright | 2024 The Authors. Diabetes/Metabolism Research and Reviews published by John Wiley & Sons Ltd. 2024. This article is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License. |
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| CorporateAuthor | INNODIA consortium, the Fr1da Study Group and the GPPAD Study Group Lunds universitet Profile areas and other strong research environments Department of Clinical Sciences, Malmö Lund University Strategiska forskningsområden (SFO) EXODIAB: Excellence of Diabetes Research in Sweden Faculty of Medicine Strategic research areas (SRA) Medicinska fakulteten Pediatrisk endokrinologi Profilområden och andra starka forskningsmiljöer Institutionen för kliniska vetenskaper, Malmö Paediatric Endocrinology |
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| References | 2015; 58 2019; 9 2015; 38 1986; 314 2021; 44 2022; 71 2020; 63 2013; 309 2023; 19 2022; 23 2019; 104 2022; 45 2022; 24 2018; 41 2020; 323 2022; 65 2012; 13 2012; 35 2012; 55 2019; 381 2021; 70 2018; 19 2016; 5 2016; 6 2004; 53 2023; 46 2023; 66 2021; 11 2019; 20 2002; 45 2022; 10 2014; 383 2001; 358 e_1_2_10_23_1 e_1_2_10_24_1 e_1_2_10_21_1 e_1_2_10_22_1 e_1_2_10_43_1 e_1_2_10_42_1 e_1_2_10_20_1 e_1_2_10_41_1 e_1_2_10_40_1 e_1_2_10_2_1 e_1_2_10_4_1 e_1_2_10_18_1 e_1_2_10_3_1 e_1_2_10_19_1 e_1_2_10_6_1 e_1_2_10_16_1 e_1_2_10_39_1 e_1_2_10_5_1 e_1_2_10_17_1 e_1_2_10_38_1 e_1_2_10_8_1 e_1_2_10_14_1 e_1_2_10_37_1 e_1_2_10_7_1 e_1_2_10_15_1 e_1_2_10_36_1 e_1_2_10_12_1 e_1_2_10_35_1 e_1_2_10_9_1 e_1_2_10_13_1 e_1_2_10_34_1 e_1_2_10_10_1 e_1_2_10_33_1 e_1_2_10_11_1 e_1_2_10_32_1 e_1_2_10_31_1 e_1_2_10_30_1 e_1_2_10_29_1 e_1_2_10_27_1 e_1_2_10_28_1 e_1_2_10_25_1 e_1_2_10_26_1 |
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| Snippet | Background/Aim
Type 1 diabetes is an autoimmune disease that involves the development of autoantibodies against pancreatic islet beta‐cell antigens, preceding... Type 1 diabetes is an autoimmune disease that involves the development of autoantibodies against pancreatic islet beta-cell antigens, preceding clinical... Background/AimType 1 diabetes is an autoimmune disease that involves the development of autoantibodies against pancreatic islet beta‐cell antigens, preceding... Background/Aim: Type 1 diabetes is an autoimmune disease that involves the development of autoantibodies against pancreatic islet beta-cell antigens, preceding... |
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| SubjectTerms | Antigens Autoantibodies Autoimmune diseases Clinical Medicine Diabetes Diabetes mellitus (insulin dependent) Diagnosis Endocrinology and Diabetes Endokrinologi och diabetes Glucose monitoring Ketoacidosis Klinisk medicin Medical and Health Sciences Medicin och hälsovetenskap monitoring presymptomatic type 1 diabetes Primary care screening specialist care staging |
| Title | Clinical care advice for monitoring of islet autoantibody positive individuals with presymptomatic type 1 diabetes |
| URI | https://onlinelibrary.wiley.com/doi/abs/10.1002%2Fdmrr.3777 https://www.ncbi.nlm.nih.gov/pubmed/38375753 https://www.proquest.com/docview/2931529898 https://www.proquest.com/docview/2928853206 |
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