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Cited by 79Diabetes and associated disordersDiabetes Management and ResearchDiabetes Management and Education

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

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Phillip, Moshe, Achenbach, Peter, Addala, Ananta, Albanese-O’Neill, Anastasia, Battelino, Tadej, Bell, Kirstine J., Besser, Rachel E.J., Bonifacio, Ezio +58 more·2024·Diabetes Care
DOI 10.2337/dci24-0042PMC PMC11381572
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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.

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Cited by

Sorted by citations

Authors
Phillip, M., Achenbach, P., Addala, A., Albanese-O’Neill, A., Battelino, T., Bell, K. J., Besser, R. E. J., Bonifacio, E., Colhoun, H. M., Couper, J. J., Craig, M. E., Danne, T., de Beaufort, C., Dovc, K., Driscoll, K. A., Dutta, S., Ebekozien, O., Elding Larsson, H., Feiten, D. J., Frohnert, B. I., Gabbay, R. A., Gallagher, M. P., Greenbaum, C. J., Griffin, K. J., Hagopian, W., Haller, M. J., Hendrieckx, C., Hendriks, E., Holt, R. I. G., Hughes, L., Ismail, H. M., Jacobsen, L. M., Johnson, S. B., Kolb, L. E., Kordonouri, O., Lange, K., Lash, R. W., Lernmark, Å., Libman, I., Lundgren, M., Maahs, D. M., Marcovecchio, M. L., Mathieu, C., Miller, K. M., O’Donnell, H. K., Oron, T., Patil, S. P., Pop-Busui, R., Rewers, M. J., Rich, S. S., Schatz, D. A., Schulman-Rosenbaum, R., Simmons, K. M., Sims, E. K., Skyler, J. S., Smith, L. B., Speake, C., Steck, A. K., Thomas, N. P. B., Tonyushkina, K. N., Veijola, R., Wentworth, J. M., Wherrett, D. K., Wood, J. R., Ziegler, A.-G., & DiMeglio, L. A.
Affiliations
  • Tel Aviv University (IL)
  • TUM Klinikum (DE)
  • Stanford Medicine (US)
  • Breakthrough T1D (US)
  • University of Ljubljana (SI)
  • The University of Sydney (AU)
  • Centre for Human Genetics (GB)
  • Paul Langerhans Institute Dresden (DE)
  • National Health Service (GB)
  • Women's and Children's Hospital (AU)
  • 21Breakthrough T1D, Lisbon
  • 22International Society for Pediatric and Adolescent Diabetes (ISPAD), Berlin, Germany
  • 8Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
  • University of Florida Health (US)
  • T1D Exchange (US)
  • 30Department of Clinical Sciences, Malmö, Lund University, Lund, Sweden
  • Breakthrough T1D UK (GB)
  • University of Colorado Anschutz (US)
  • American Diabetes Association (US)
  • NYU Langone Health (US)
  • Benaroya Research Institute (US)
  • University of South Dakota (US)
  • Pacific Northwest Research Institute (US)
  • Deakin University (AU)
  • University of Cambridge (GB)
  • University Hospital Southampton NHS Foundation Trust (GB)
  • 46Mount Sinai South Nassau, Oceanside, NY
  • Indiana University Indianapolis (US)
  • Florida State University (US)
  • 49Association of Diabetes Care & Education Specialists, Chicago, IL
  • Medizinische Hochschule Hannover (DE)
  • Endocrine Society (US)
  • Lund University (SE)
  • University of Pittsburgh (US)
  • Cambridge University Hospitals NHS Foundation Trust (GB)
  • Universitair Ziekenhuis Leuven (BE)
  • East Carolina University (US)
  • 57Department of Internal Medicine, Division of Metabolism, Endocrinology and Diabetes, University of Michigan, Ann Arbor, MI
  • University of Virginia (US)
  • 60Division of Endocrinology, Long Island Jewish Medical Center, Northwell Health, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, New Hyde Park, NY
  • University of Miami (US)
  • Cincinnati Children's Hospital Medical Center (US)
  • Clinical Research Network Thames Valley and South Midlands (GB)
  • Baystate Medical Center (US)
  • Oulu University Hospital (FI)
  • The Royal Melbourne Hospital (AU)
  • University of Toronto (CA)
  • University Hospitals of Cleveland (US)
Corresponding author
Albanese-O’Neill, Anastasia
ORCID
Venue
Diabetes Care
Publisher
American Diabetes Association
Published
2024-06-24
Volume
47
Issue
8
Pages
1276-1298
ISSN
  • 0149-5992 (ISSN-L)
  • 1935-5548
DOI
10.2337/dci24-0042
PMC
PMC11381572
OpenAlex
W4399985820
Cited by
79
References
22
Citations by year
2026: 27 · 2025: 39 · 2024: 13
FWCI
20.97
Type
journal article
Language
en
Update notices
correction (2024-09-06)
Open access
Licence
www.diabetesjournals.org/journals/pages/license (vor)
Locations
  • Diabetes Care (publishedVersion)
  • PubMed Central (publishedVersion)
  • Europe PMC (PubMed Central) (publishedVersion)
  • PubMed (publishedVersion)
  • Lirias (KU Leuven) (submittedVersion)
  • Lund University Publications (Lund University) (submittedVersion)
  • mediaTUM – the media and publications repository of the Technical University Munich (Technical University Munich) (submittedVersion)
  • PuSH - Publication Server of Helmholtz Zentrum München (submittedVersion)
Funders
  • National Science Foundation
  • American Diabetes Association
  • Eli Lilly and Company
  • Pfizer
  • AstraZeneca
  • Bayer
  • Sanofi
  • Leona M. and Harry B. Helmsley Charitable Trust
  • Clinical Trial Center, China Medical University Hospital
  • Juvenile Diabetes Research Foundation United States of America
  • Vertex Pharmaceuticals
  • UK Research and Innovation
  • Bigfoot Biomedical
  • Insulet Corporation
  • MannKind Corporation
  • Dexcom
  • Tandem Diabetes Care
  • Diabetes UK
  • Australian Diabetes Society
  • KU Leuven
  • Novo Nordisk
  • European Association for the Study of Diabetes
  • International Society for Pediatric and Adolescent Diabetes
  • National Institutes of Health
  • Medical Research Council
  • National Institute of Diabetes and Digestive and Kidney Diseases (U01DK119083)
  • Janssen Pharmaceuticals
Topics
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Diabetes and associated disorders
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Education
Keywords
type 1 diabetes, islet autoantibodies, disease progression monitoring, type 1 diabetes screening, diabetic ketoacidosis, primary care partnerships, psychosocial support, patient education, disease-modifying therapy, consensus recommendations
MeSH terms
Autoantibodies, Diabetes Mellitus, Type 1, Humans, Islets of Langerhans, Consensus

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