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

作者：Moshe Phillip, Peter Achenbach, Ananta Addala, Anastasia Albanese-O’Neill, Tadej Battelino, Kirstine J. Bell, Rachel E.J. Besser, Ezio E. Bonifacio, Helen Martina Colhoun, Jennifer Couper, Maria E. Craig, Thomas Danne, Carine E. de Beaufort, Klemen Dovč, Kimberly A. Driscoll, Sanjoy Dutta, Osagie A. Ebekozien, Helena Elding Larsson, Daniel J. Feiten, Brigitte I. Frohnert, Robert A. Gabbay, MARY PAT GALLAGHER, Carla J. Greenbaum, Kurt Griffin, William Hagopian, Michael J. Haller, Christel Hendrieckx, Emile Hendriks, Richard I. G. Holt, Lucille Hughes, Heba Mohamed Atif Ismail, Laura M. Jacobsen, Suzanne Bennett Johnson, Leslie E. Kolb, Olga Kordonouri, Karin Lange, Robert W. Lash, Åke Lernmark, Ingrid M. Libman, Markus Lundgren, David M. Maahs, Maria Loredana Marcovecchio, Chantal Mathieu, Kellee M. Miller, Holly K. O’Donnell, Tal Oron, Shivajirao Prakash Patil, Rodica Pop‐Busui, Marian Rewers, Stephen S. Rich, Desmond Schatz, Rifka Schulman‐Rosenbaum, Kimber M. Simmons, Emily K. Sims, Jay S. Skyler, LAURA B. SMITH, Cate Speake, Andrea K. Steck, Nicholas P B Thomas, Ksenia N. Tonyushkina, Riitta Veijola, John M. Wentworth, Diane K. Wherrett, Jamie Wood, Anette‐Gabriele Ziegler, Linda Anne DiMeglio · 发表于：Diabetologia · 年份：2024 · DOI：10.1007/s00125-024-06205-5 · 被引用次数：65 · 研究领域：Diabetes and associated disorders、Pancreatic function and diabetes、Diabetes Management and Research

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 therapie...