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

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

Journal article

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

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 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:

Publication status:: Published

Peer review status:: Peer reviewed

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APA Style

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., Larsson, H. E., Feiten, D. J., … Griffin, K. J. (2024). Consensus guidance for monitoring individuals with islet autoantibody-positive pre-stage 3 type 1 diabetes. Diabetologia, 67(9), 1731–1759.

MLA Style

Phillip, M., et al. “Consensus Guidance for Monitoring Individuals with Islet Autoantibody-Positive Pre-Stage 3 Type 1 Diabetes.” Diabetologia, vol. 67, no. 9, Springer, 2024, pp. 1731–59.

Chicago Style

Phillip, M, P Achenbach, A Addala, A Albanese-O’Neill, T Battelino, KJ Bell, REJ Besser, et al. 2024. “Consensus Guidance for Monitoring Individuals with Islet Autoantibody-Positive Pre-Stage 3 Type 1 Diabetes.” Diabetologia 67 (9): 1731–59.
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