Screening for type 1 diabetes: are we nearly there yet?

Narendran, Parth

doi:10.1007/s00125-018-4774-0

Cited by 10 publications

(4 citation statements)

References 22 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Among the paediatric T1D group, patients with decompensation at diagnosis were younger compared to the control group. Diabetes manifestation in younger children may be misdiagnosed when presenting at the doctor’s office as having pneumonia or asthma, even worsening the condition by inappropriate treatment, possibly leading to serious long-term effects or death [ 12 , 22 , 23 ].…”

Section: Discussionmentioning

confidence: 99%

Multicentre analysis of hyperglycaemic hyperosmolar state and diabetic ketoacidosis in type 1 and type 2 diabetes

et al. 2020

View full text Add to dashboard Cite

Aims To compare diabetes patients with hyperglycaemic hyperosmolar state (HHS), diabetic ketoacidosis (DKA), and patients without decompensation (ND). Methods In total, 500,973 patients with type 1 or type 2 diabetes of all ages registered in the diabetes patient follow-up (DPV) were included. Analysis was stratified by age (≤ / > 20 years) and by manifestation/follow-up. Patients were categorized into three groups: HHS or DKA—during follow-up according to the most recent episode—or ND. Results At onset of diabetes, HHS criteria were met by 345 (68.4% T1D) and DKA by 9824 (97.6% T1D) patients. DKA patients had a lower BMI(-SDS) in both diabetes types compared to ND. HbA1c was higher in HHS/DKA. During follow-up, HHS occurred in 1451 (42.2% T1D) and DKA in 8389 patients (76.7% T1D). In paediatric T1D, HHS/DKA was associated with younger age, depression, and dyslipidemia. Pump usage was less frequent in DKA patients. In adult T1D/T2D subjects, metabolic control was worse in patients with HHS/DKA. HHS and DKA were also associated with excessive alcohol intake, dementia, stroke, chronic kidney disease, and depression. Conclusions HHS/DKA occurred mostly in T1D and younger patients. However, both also occurred in T2D, which is of great importance in the treatment of diabetes. Better education programmes are necessary to prevent decompensation and comorbidities.

show abstract

Section: Discussionmentioning

confidence: 99%

Multicentre analysis of hyperglycaemic hyperosmolar state and diabetic ketoacidosis in type 1 and type 2 diabetes

et al. 2020

View full text Add to dashboard Cite

show abstract

“…Providers agreed that a major benefit to screening is its ability to detect diabetes early and thereby prevent DKA at the time of diagnosis, leading to lower A1C levels ( 26 ). Early awareness can be lifesaving and can help to prevent the development of complications in the future ( 27 ). Early awareness can also offer people the opportunity to get involved in research or clinical trials and can potentially reduce stress associated with diagnosis ( 28 ).…”

Section: Discussionmentioning

confidence: 99%

Understanding Providers’ Readiness and Attitudes Toward Autoantibody Screening: A Mixed-Methods Study

Ospelt,

Hardison,

Rioles

et al. 2023

Clinical Diabetes

View full text Add to dashboard Cite

Screening for autoantibodies associated with type 1 diabetes can identify people most at risk for progressing to clinical type 1 diabetes and provide an opportunity for early intervention. Drawbacks and barriers to screening exist, and concerns arise, as methods for disease prevention are limited and no cure exists today. The availability of novel treatment options such as teplizumab to delay progression to clinical type 1 diabetes in high-risk individuals has led to the reassessment of screening programs. This study explored awareness, readiness, and attitudes of endocrinology providers toward type 1 diabetes autoantibody screening.

show abstract

“…At the same time, HOMA2-B's simplicity and scalability make it an appealing measure for use in larger, epidemiological studies and population-based screening efforts. Studies have demonstrated that individuals who have been screened for type 1 diabetes risk are less likely to present with diabetic ketoacidosis (DKA) and more likely to have a lower HbA 1c at diagnosis [37]. Recent publication of the Fr1da study group's results demonstrated the feasibility of primary-care-based screening for islet autoantibodies after screening over 90,000 children aged 2-5 years in Bavaria, Germany [38].…”

Section: Discussionmentioning

confidence: 99%

HOMA2-B enhances assessment of type 1 diabetes risk among TrialNet Pathway to Prevention participants

et al. 2021

View full text Add to dashboard Cite

Aims/hypothesis Methods to identify individuals at highest risk for type 1 diabetes are essential for the successful implementation of disease-modifying interventions. Simple metabolic measures are needed to help stratify autoantibody-positive (Aab+) individuals who are at risk of developing type 1 diabetes. HOMA2-B is a validated mathematical tool commonly used to estimate beta cell function in type 2 diabetes using fasting glucose and insulin. The utility of HOMA2-B in association with type 1 diabetes progression has not been tested. Methods Baseline HOMA2-B values from single-Aab+ (n = 2652; mean age, 21.1 ± 14.0 years) and multiple-Aab+ (n = 3794; mean age, 14.5 ± 11.2 years) individuals enrolled in the TrialNet Pathway to Prevention study were compared. Cox proportional hazard models were used to determine associations between HOMA2-B tertiles and time to progression to type 1 diabetes, with adjustments for age, sex, HLA status and BMI z score. Receiver operating characteristic (ROC) analysis was used to test the association of HOMA2-B with type 1 diabetes development in 1, 2, 5 and 10 years. Results At study entry, HOMA2-B values were higher in single-compared with multiple-Aab+ Pathway to Prevention participants (91.1 ± 44.5 vs 83.9 ± 38.9; p < 0.001). Single-and multiple-Aab+ individuals in the lowest HOMA2-B tertile had a higher risk and faster rate of progression to type 1 diabetes. For progression to type 1 diabetes within 1 year, area under the ROC curve (AUC-ROC) was 0.685, 0.666 and 0.680 for all Aab+, single-Aab+ and multiple-Aab+ individuals, respectively. When correlation between HOMA2-B and type 1 diabetes risk was assessed in combination with additional factors known to influence type 1 diabetes progression (insulin sensitivity, age and HLA status), AUC-ROC was highest for the single-Aab+ group's risk of progression at 2 years (AUC-ROC 0.723 [95% CI 0.652, 0.794]). Conclusions/interpretation These data suggest that HOMA2-B may have utility as a single-time-point measurement to stratify risk of type 1 diabetes development in Aab+ individuals.A complete list of Type 1 Diabetes TrialNet Study Group members is included in the electronic supplementary material (ESM).

show abstract

Screening for type 1 diabetes: are we nearly there yet?

Cited by 10 publications

References 22 publications

Multicentre analysis of hyperglycaemic hyperosmolar state and diabetic ketoacidosis in type 1 and type 2 diabetes

Multicentre analysis of hyperglycaemic hyperosmolar state and diabetic ketoacidosis in type 1 and type 2 diabetes

Understanding Providers’ Readiness and Attitudes Toward Autoantibody Screening: A Mixed-Methods Study

HOMA2-B enhances assessment of type 1 diabetes risk among TrialNet Pathway to Prevention participants

Contact Info

Product

Resources

About