Review

. 2024 Aug 1;47(8):1276-1298.

doi: 10.2337/dci24-0042.

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

Moshe Phillip^{1

2}, Peter Achenbach^{3

4}, Ananta Addala^{5

6}, Anastasia Albanese-O'Neill⁷, Tadej Battelino^{8

9}, Kirstine J Bell¹⁰, Rachel E J Besser^{11

12}, Ezio Bonifacio^{13

14}, Helen M Colhoun^{15

16}, Jennifer J Couper^{17

18

19}, Maria E Craig^{10

20}, Thomas Danne²¹, Carine de Beaufort^{22

23

24}, Klemen Dovc^{8

9}, Kimberly A Driscoll^{25

26

27}, Sanjoy Dutta²⁸, Osagie Ebekozien²⁹, Helena Elding Larsson^{30

31}, Daniel J Feiten³², Brigitte I Frohnert²⁵, Robert A Gabbay³³, Mary P Gallagher³⁴, Carla J Greenbaum³⁵, Kurt J Griffin^{36

37}, William Hagopian³⁸, Michael J Haller^{27

39}, Christel Hendrieckx^{40

41

42}, Emile Hendriks⁴³, Richard I G Holt^{44

45}, Lucille Hughes⁴⁶, Heba M Ismail⁴⁷, Laura M Jacobsen³⁹, Suzanne B Johnson⁴⁸, Leslie E Kolb⁴⁹, Olga Kordonouri²¹, Karin Lange⁵⁰, Robert W Lash⁵¹, Åke Lernmark³⁰, Ingrid Libman⁵², Markus Lundgren^{30

53}, David M Maahs⁵, M Loredana Marcovecchio⁵⁴, Chantal Mathieu⁵⁵, Kellee M Miller²⁹, Holly K O'Donnell²⁵, Tal Oron^{1

2}, Shivajirao P Patil⁵⁶, Rodica Pop-Busui⁵⁷, Marian J Rewers²⁵, Stephen S Rich⁵⁸, Desmond A Schatz⁵⁹, Rifka Schulman-Rosenbaum⁶⁰, Kimber M Simmons²⁵, Emily K Sims⁶¹, Jay S Skyler⁶², Laura B Smith⁶³, Cate Speake³⁵, Andrea K Steck²⁵, Nicholas P B Thomas⁶⁴, Ksenia N Tonyushkina⁶⁵, Riitta Veijola⁶⁶, John M Wentworth^{67

68}, Diane K Wherrett⁶⁹, Jamie R Wood⁷⁰, Anette-Gabriele Ziegler^{3

4}, Linda A DiMeglio⁴⁶

Affiliations

¹ Institute for Endocrinology and Diabetes, National Center for Childhood Diabetes, Schneider Children's Medical Center of Israel, Petah Tikva, Israel.
² Faculty of Medical and Health Sciences, Tel Aviv University, Tel Aviv, Israel.
³ Institute of Diabetes Research, Helmholtz Zentrum München, German Research Center for Environmental Health, Munich-Neuherberg, Germany.
⁴ Forschergruppe Diabetes, Technical University Munich, Klinikum Rechts Der Isar, Munich, Germany.
⁵ Division of Endocrinology, Department of Pediatrics, Stanford University School of Medicine, Stanford, CA.
⁶ Stanford Diabetes Research Center, Stanford University School of Medicine, Stanford, CA.
⁷ Breakthrough T1D, Gainesville, FL.
⁸ Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia.
⁹ Department of Endocrinology, Diabetes and Metabolism, University Medical Centre Ljubljana, Ljubljana, Slovenia.
¹⁰ Charles Perkins Centre and Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia.
¹¹ JDRF/Wellcome Diabetes and Inflammation Laboratory, Wellcome Centre Human Genetics, Nuffield Department of Medicine Oxford National Institute for Health and Care Research Biomedical Research Centre, University of Oxford, Oxford, U.K.
¹² Department of Paediatrics, University of Oxford, Oxford, U.K.
¹³ Center for Regenerative Therapies Dresden, Faculty of Medicine, Technical University of Dresden, Dresden, Germany.
¹⁴ Paul Langerhans Institute Dresden, Helmholtz Centre Munich at the University Clinic Carl Gustav Carus of Technical University of Dresden, and Faculty of Medicine, Technical University of Dresden, Dresden, Germany.
¹⁵ The Institute of Genetics and Cancer, University of Edinburgh, Edinburgh, U.K.
¹⁶ Department of Public Health, NHS Fife, Kirkcaldy, U.K.
¹⁷ Robinson Research Institute, The University of Adelaide, Adelaide, South Australia, Australia.
¹⁸ Adelaide Medical School, The University of Adelaide, Adelaide, South Australia, Australia.
¹⁹ Division of Paediatrics, Women's and Children's Hospital, Adelaide, South Australia, Australia.
²⁰ Discipline of Paediatrics & Child Health, School of Clinical Medicine, UNSW Medicine & Health, Sydney, New South Wales, Australia.
²¹ Breakthrough T1D, Lisbon.
²² International Society for Pediatric and Adolescent Diabetes (ISPAD), Berlin, Germany.
²³ Diabetes & Endocrine Care Clinique Pédiatrique (DECCP), Clinique Pédiatrique/Centre Hospitalier (CH) de Luxembourg, Luxembourg City, Luxembourg.
²⁴ Faculty of Science, Technology and Medicine, University of Luxembourg, Esch-Belval, Luxembourg.
²⁵ Department of Pediatrics, Barbara Davis Center for Diabetes, University of Colorado Anschutz Medical Campus, Aurora, CO.
²⁶ Department of Clinical and Health Psychology, University of Florida, Gainesville, FL.
²⁷ Department of Pediatrics, University of Florida Diabetes Institute, Gainesville, FL.
²⁸ Breakthrough T1D, New York, NY.
²⁹ T1D Exchange, Boston, MA.
³⁰ Department of Clinical Sciences, Malmö, Lund University, Lund, Sweden.
³¹ Department of Pediatrics, Skåne University Hospital, Malmö and Lund, Sweden.
³² Children's Diabetes Foundation, Aurora, CO.
³³ American Diabetes Association, Arlington, VA.
³⁴ NYU Langone Medical Center, New York, NY.
³⁵ Center for Interventional Immunology and Diabetes Program, Benaroya Research Institute, Seattle, WA.
³⁶ Sanford Research, Sioux Falls, SD.
³⁷ Department of Pediatrics, Sanford School of Medicine, University of South Dakota, Sioux Falls, SD.
³⁸ Pacific Northwest Diabetes Research Institute, University of Washington, Seattle, WA.
³⁹ Division of Endocrinology, University of Florida College of Medicine, Gainesville, FL.
⁴⁰ School of Psychology, Deakin University, Geelong, Victoria, Australia.
⁴¹ The Australian Centre for Behavioural Research in Diabetes, Diabetes Victoria, Carlton, Victoria, Australia.
⁴² Institute for Health Transformation, Deakin University, Geelong, Victoria, Australia.
⁴³ Department of Paediatrics, University of Cambridge and Cambridge University Hospitals NHS Foundation Trust, Cambridge, U.K.
⁴⁴ Human Development and Health, Faculty of Medicine, University of Southampton, Southampton, U.K.
⁴⁵ National Institute for Health and Care Research Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, U.K.
⁴⁶ Mount Sinai South Nassau, Oceanside, NY.
⁴⁷ Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN.
⁴⁸ Department of Behavioral Sciences and Social Medicine, Florida State University College of Medicine, Tallahassee, FL.
⁴⁹ Association of Diabetes Care & Education Specialists, Chicago, IL.
⁵⁰ Medical Psychology, Hannover Medical School, Hannover, Germany.
⁵¹ Endocrine Society, Washington, DC.
⁵² Division of Pediatric Endocrinology and Diabetes, University of Pittsburgh, University of Pittsburgh Medical Center Children's Hospital of Pittsburgh, PA.
⁵³ Department of Pediatrics, Kristianstad Hospital, Kristianstad, Sweden.
⁵⁴ Department of Pediatrics, Cambridge University Hospitals NHS Foundation Trust, Cambridge, U.K.
⁵⁵ Department of Endocrinology, UZ Gasthuisberg, KU Leuven, Leuven, Belgium.
⁵⁶ Department of Family Medicine, Brody School of Medicine, East Carolina University, Greenville, NC.
⁵⁷ Department of Internal Medicine, Division of Metabolism, Endocrinology and Diabetes, University of Michigan, Ann Arbor, MI.
⁵⁸ Center for Public Health Genomics, University of Virginia, Charlottesville, VA.
⁵⁹ Department of Pediatrics, University of Florida, Gainesville, FL.
⁶⁰ Division of Endocrinology, Long Island Jewish Medical Center, Northwell Health, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, New Hyde Park, NY.
⁶¹ Division of Pediatric Endocrinology and Diabetology, Herman B Wells Center for Pediatric Research, Center for Diabetes and Metabolic Diseases, Indiana University School of Medicine, Indianapolis, IN.
⁶² Diabetes Research Institute, University of Miami Miller School of Medicine, Miami, FL.
⁶³ Cincinnati Children's Hospital Medical Center, Cincinnati, OH.
⁶⁴ National Institute of Health and Care Research Clinical Research Network Thames Valley and South Midlands, Oxford, U.K.
⁶⁵ Division of Endocrinology and Diabetes, Baystate Children's Hospital and University of Massachusetts Chan Medical School-Baystate, Springfield, MA.
⁶⁶ Research Unit of Clinical Medicine, Department of Pediatrics, Medical Research Center, Oulu University Hospital and University of Oulu, Oulu, Finland.
⁶⁷ The Walter and Eliza Hall Institute of Medical Research, Parkville, Victoria, Australia.
⁶⁸ Department of Diabetes and Endocrinology, Royal Melbourne Hospital, Parkville, Victoria, Australia.
⁶⁹ Department of Paediatrics, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada.
⁷⁰ Department of Pediatric Endocrinology, Rainbow Babies and Children's Hospital, University Hospitals Cleveland Medical Center, Cleveland, OH.

PMID: 38912694
PMCID: PMC11381572
DOI: 10.2337/dci24-0042

Review

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

Moshe Phillip et al. Diabetes Care. 2024.

. 2024 Aug 1;47(8):1276-1298.

doi: 10.2337/dci24-0042.

Authors

Affiliations

¹ Institute for Endocrinology and Diabetes, National Center for Childhood Diabetes, Schneider Children's Medical Center of Israel, Petah Tikva, Israel.
² Faculty of Medical and Health Sciences, Tel Aviv University, Tel Aviv, Israel.
³ Institute of Diabetes Research, Helmholtz Zentrum München, German Research Center for Environmental Health, Munich-Neuherberg, Germany.
⁴ Forschergruppe Diabetes, Technical University Munich, Klinikum Rechts Der Isar, Munich, Germany.
⁵ Division of Endocrinology, Department of Pediatrics, Stanford University School of Medicine, Stanford, CA.
⁶ Stanford Diabetes Research Center, Stanford University School of Medicine, Stanford, CA.
⁷ Breakthrough T1D, Gainesville, FL.
⁸ Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia.
⁹ Department of Endocrinology, Diabetes and Metabolism, University Medical Centre Ljubljana, Ljubljana, Slovenia.
¹⁰ Charles Perkins Centre and Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia.
¹¹ JDRF/Wellcome Diabetes and Inflammation Laboratory, Wellcome Centre Human Genetics, Nuffield Department of Medicine Oxford National Institute for Health and Care Research Biomedical Research Centre, University of Oxford, Oxford, U.K.
¹² Department of Paediatrics, University of Oxford, Oxford, U.K.
¹³ Center for Regenerative Therapies Dresden, Faculty of Medicine, Technical University of Dresden, Dresden, Germany.
¹⁴ Paul Langerhans Institute Dresden, Helmholtz Centre Munich at the University Clinic Carl Gustav Carus of Technical University of Dresden, and Faculty of Medicine, Technical University of Dresden, Dresden, Germany.
¹⁵ The Institute of Genetics and Cancer, University of Edinburgh, Edinburgh, U.K.
¹⁶ Department of Public Health, NHS Fife, Kirkcaldy, U.K.
¹⁷ Robinson Research Institute, The University of Adelaide, Adelaide, South Australia, Australia.
¹⁸ Adelaide Medical School, The University of Adelaide, Adelaide, South Australia, Australia.
¹⁹ Division of Paediatrics, Women's and Children's Hospital, Adelaide, South Australia, Australia.
²⁰ Discipline of Paediatrics & Child Health, School of Clinical Medicine, UNSW Medicine & Health, Sydney, New South Wales, Australia.
²¹ Breakthrough T1D, Lisbon.
²² International Society for Pediatric and Adolescent Diabetes (ISPAD), Berlin, Germany.
²³ Diabetes & Endocrine Care Clinique Pédiatrique (DECCP), Clinique Pédiatrique/Centre Hospitalier (CH) de Luxembourg, Luxembourg City, Luxembourg.
²⁴ Faculty of Science, Technology and Medicine, University of Luxembourg, Esch-Belval, Luxembourg.
²⁵ Department of Pediatrics, Barbara Davis Center for Diabetes, University of Colorado Anschutz Medical Campus, Aurora, CO.
²⁶ Department of Clinical and Health Psychology, University of Florida, Gainesville, FL.
²⁷ Department of Pediatrics, University of Florida Diabetes Institute, Gainesville, FL.
²⁸ Breakthrough T1D, New York, NY.
²⁹ T1D Exchange, Boston, MA.
³⁰ Department of Clinical Sciences, Malmö, Lund University, Lund, Sweden.
³¹ Department of Pediatrics, Skåne University Hospital, Malmö and Lund, Sweden.
³² Children's Diabetes Foundation, Aurora, CO.
³³ American Diabetes Association, Arlington, VA.
³⁴ NYU Langone Medical Center, New York, NY.
³⁵ Center for Interventional Immunology and Diabetes Program, Benaroya Research Institute, Seattle, WA.
³⁶ Sanford Research, Sioux Falls, SD.
³⁷ Department of Pediatrics, Sanford School of Medicine, University of South Dakota, Sioux Falls, SD.
³⁸ Pacific Northwest Diabetes Research Institute, University of Washington, Seattle, WA.
³⁹ Division of Endocrinology, University of Florida College of Medicine, Gainesville, FL.
⁴⁰ School of Psychology, Deakin University, Geelong, Victoria, Australia.
⁴¹ The Australian Centre for Behavioural Research in Diabetes, Diabetes Victoria, Carlton, Victoria, Australia.
⁴² Institute for Health Transformation, Deakin University, Geelong, Victoria, Australia.
⁴³ Department of Paediatrics, University of Cambridge and Cambridge University Hospitals NHS Foundation Trust, Cambridge, U.K.
⁴⁴ Human Development and Health, Faculty of Medicine, University of Southampton, Southampton, U.K.
⁴⁵ National Institute for Health and Care Research Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, U.K.
⁴⁶ Mount Sinai South Nassau, Oceanside, NY.
⁴⁷ Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN.
⁴⁸ Department of Behavioral Sciences and Social Medicine, Florida State University College of Medicine, Tallahassee, FL.
⁴⁹ Association of Diabetes Care & Education Specialists, Chicago, IL.
⁵⁰ Medical Psychology, Hannover Medical School, Hannover, Germany.
⁵¹ Endocrine Society, Washington, DC.
⁵² Division of Pediatric Endocrinology and Diabetes, University of Pittsburgh, University of Pittsburgh Medical Center Children's Hospital of Pittsburgh, PA.
⁵³ Department of Pediatrics, Kristianstad Hospital, Kristianstad, Sweden.
⁵⁴ Department of Pediatrics, Cambridge University Hospitals NHS Foundation Trust, Cambridge, U.K.
⁵⁵ Department of Endocrinology, UZ Gasthuisberg, KU Leuven, Leuven, Belgium.
⁵⁶ Department of Family Medicine, Brody School of Medicine, East Carolina University, Greenville, NC.
⁵⁷ Department of Internal Medicine, Division of Metabolism, Endocrinology and Diabetes, University of Michigan, Ann Arbor, MI.
⁵⁸ Center for Public Health Genomics, University of Virginia, Charlottesville, VA.
⁵⁹ Department of Pediatrics, University of Florida, Gainesville, FL.
⁶⁰ Division of Endocrinology, Long Island Jewish Medical Center, Northwell Health, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, New Hyde Park, NY.
⁶¹ Division of Pediatric Endocrinology and Diabetology, Herman B Wells Center for Pediatric Research, Center for Diabetes and Metabolic Diseases, Indiana University School of Medicine, Indianapolis, IN.
⁶² Diabetes Research Institute, University of Miami Miller School of Medicine, Miami, FL.
⁶³ Cincinnati Children's Hospital Medical Center, Cincinnati, OH.
⁶⁴ National Institute of Health and Care Research Clinical Research Network Thames Valley and South Midlands, Oxford, U.K.
⁶⁵ Division of Endocrinology and Diabetes, Baystate Children's Hospital and University of Massachusetts Chan Medical School-Baystate, Springfield, MA.
⁶⁶ Research Unit of Clinical Medicine, Department of Pediatrics, Medical Research Center, Oulu University Hospital and University of Oulu, Oulu, Finland.
⁶⁷ The Walter and Eliza Hall Institute of Medical Research, Parkville, Victoria, Australia.
⁶⁸ Department of Diabetes and Endocrinology, Royal Melbourne Hospital, Parkville, Victoria, Australia.
⁶⁹ Department of Paediatrics, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada.
⁷⁰ Department of Pediatric Endocrinology, Rainbow Babies and Children's Hospital, University Hospitals Cleveland Medical Center, Cleveland, OH.

PMID: 38912694
PMCID: PMC11381572
DOI: 10.2337/dci24-0042

Erratum in

Erratum. Consensus Guidance for Monitoring Individuals With Islet Autoantibody-Positive Pre-Stage 3 Type 1 Diabetes. Diabetes Care 2024;47:1276-1298.
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, Beaufort C, Dovc K, Driscoll KA, Dutta S, Ebekozien O, Larsson HE, Feiten DJ, Frohnert BI, Gabbay RA, Gallagher MP, Greenbaum CJ, Griffin KJ, Hagopian W, Haller MJ, Hendrieckx C, Hendriks E, Holt RIG, Hughes L, Ismail HM, Jacobsen LM, Johnson SB, Kolb LE, Kordonouri O, Lange K, Lash RW, Lernmark Å, Libman I, Lundgren M, Maahs DM, Marcovecchio ML, Mathieu C, Miller KM, O'Donnell HK, Oron T, Patil SP, Pop-Busui R, Rewers MJ, Rich SS, Schatz DA, Schulman-Rosenbaum R, Simmons KM, Sims EK, Skyler JS, Smith LB, Speake C, Steck AK, Thomas NPB, Tonyushkina KN, Veijola R, Wentworth JM, Wherrett DK, Wood JR, Ziegler AG, DiMeglio LA. Phillip M, et al. Diabetes Care. 2024 Nov 1;47(11):2033. doi: 10.2337/dc24-er11a. Diabetes Care. 2024. PMID: 39240700 Free PMC article. No abstract available.

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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Conflict of interest statement

Duality of Interest. M.P. has received honoraria for participation on advisory boards for AstraZeneca, Eli Lilly, MannKind Corp., Medtronic Diabetes, Pfizer, Sanofi, Dompé, LifeScan, Novo Nordisk, Insulet, Provention Bio, Merck, Ascensia Diabetes Care, Bayer, Embecta, and Tandem Diabetes Care and as a speaker for Eli Lilly, Medtronic Diabetes, Novo Nordisk, Pfizer, Sanofi, and Ascensia Diabetes Care. M.P. owns stocks of DreaMed Diabetes and NG Solutions, and his institution has received research grant support from Eli Lilly, Medtronic Diabetes, Novo Nordisk, Pfizer, Sanofi, DreaMed Diabetes, NG Solutions, Dompé, Lumos, GWave, OPKO, Provention Bio, and AstraZeneca, travel expenses from Medtronic Diabetes and Sanofi, and consulting fees from Qulab Medical and Provention Bio. T.B. served on advisory boards of Novo Nordisk, Sanofi, Eli Lilly, Boehringer Ingelheim, Medtronic, Abbott, and Indigo Diabetes. T.B. received honoraria for participating on the speakers bureau for Eli Lilly, Novo Nordisk, Medtronic, Abbott, Sanofi, Dexcom, Adventis, AstraZeneca, and Roche. T.B.’s institution has received research grant support and travel expenses from Abbott, Medtronic, Novo Nordisk, Sanofi, Novartis, Sandoz, and Zealand Pharma. R.E.J.B. has received consulting fees from Provention Bio. H.M.C. has received research grant support from IQVIA, JDRF, Chief Scientist Office, Diabetes UK, and the UK Medical Research Council (UKRI). H.M.C. has received honorarium from Novo Nordisk and owns shares in Roche Pharmaceuticals and Bayer AG. T.D. has received honoraria and speaker honoraria and consulting fees and his former institution has received research support from Abbott, AstraZeneca, Boehringer Ingelheim, Dexcom, Eli Lilly, Novo Nordisk, Provention Bio, Sanofi, and Vertex Pharmaceuticals. He is a shareholder in DreamMed, Ltd. K.D. has received honorarium for participation on advisory boards for Medtronic and Novo Nordisk and speaker fees from Abbott, Eli Lilly, Novo Nordisk, Medtronic, and Pfizer. O.E. has received research support from MannKind Corp., Medtronic Diabetes, Abbott, Dexcom, Eli Lilly Pharmaceuticals, Janssen Pharmaceuticals, and Vertex Pharmaceuticals. O.E. has also participated on advisory boards for Medtronic and Sanofi. O.E. has received consultation and speaker fees from Medtronic Diabetes, Sanofi, and Vertex. All financial support from industry for O.E. has been through his organization, T1D Exchange. R.A.G. has received honorarium from Lark, Sweetch, StartUp Health, Vida, and Valendo. C.J.G.'s institution received payment from Sanofi as a clinical trial center. K.J.G. has received sponsored travel from JDRF. W.H. received grant/consultancy fees from Sanofi/Provention Bio. M.J.H. has received grants or consultancy fees from Sanofi, MannKind Corp., and SAB Biotherapeutics and is a stock options holder of SAB Biotherapeutics. R.I.G.H. has received honoraria for speaking from EASD, Eli Lilly, ENCORE, Liberum, Novo Nordisk, Rovi, and Boehringer Ingelheim. R.I.G.H. has received conference funding from Novo Nordisk and Eli Lilly. O.K. has received honoraria and lecture fees from Sanofi, Dexcom, and Medtronic. R.W.L. has received a consultancy fee from Cigna Insurance. D.M.M. has received research support from the National Institutes of Health, JDRF, National Science Foundation, and the Leona M. and Harry B. Helmsley Charitable Trust, and his institution has had research support from Medtronic, Dexcom, Insulet, Bigfoot Biomedical, Tandem Diabetes Care, and Roche. C.M. serves or has served on advisory panels for Novo Nordisk, Sanofi, Eli Lilly and Company, Novartis, Boehringer Ingelheim, Roche, Medtronic, Imcyse, Insulet, Biomea Fusion, and Vertex Pharmaceuticals. Financial compensation for these activities has been received by KU Leuven; KU Leuven has received research support for C.M. from Medtronic, Imcyse, Novo Nordisk, Sanofi, and ActoBio Therapeutics. C.M. serves or has served on speakers bureaus for Novo Nordisk, Sanofi, Eli Lilly and Company, Medtronic, and Boehringer Ingelheim. Financial compensation for these activities has been received by KU Leuven. C.M. is president of EASD. All external support of EASD is to be found on www.easd.org. H.K.O.’D. received compensation from Sanofi for attending their advisory board and for speaking at ADA 84th Scientific Sessions. R.P.-B. has received payment or honoraria from Bayer, Lexicon Pharma, Novo Nordisk, Averitas Pharma, Nevro, Roche, and Medtronic. M.J.R. has received honoraria and grants from Sanofi. K.M.S. has received consultancy fees, grants, or honoraria from Provention Bio and Sanofi. E.K.S. has received consulting fees from Sanofi and DRI Healthcare and has received payment for lectures from Health Matters CME, Medscape, Med Learning Group LLC, and the ADA. J.S.S. has been a scientific advisory board member for 4Immune, ActoBiotics, Avotres, and Quell Therapeutics. J.S.S. has been a data safety board member for Imcyse and Provention Bio and is a member of the board of directors for SAB Therapeutics. J.S.S. has been an advisor or consultant for ImmunoMolecular Therapeutics, Novo Nordisk, Remedy Plan, Inc., SAB Therapeutics, and Sanofi. J.S.S. has shares in or is an option holder for 4Immune, Avotres, ImmunoMolecular Therapeutics, Remedy Plan, Inc., and SAB Therapeutics. C.S. has received research funding from Cour Pharmaceuticals and consultancy fees from Sanofi and GentiBio. L.A.D. has received research support to their institution from Dompé, Lilly, MannKind Corp., Medtronic, Provention/Sanofi, and Zealand and consulting fees from Vertex Pharmaceuticals and Abata. L.A.D. has a patent pending for difluoromethylornithine (DFMO). No other potential conflicts of interest relevant to this article were reported.

Figures

**Figure 1**
Algorithm for monitoring of people screened positive for one or more islet autoantibodies. *Monitoring frequency and methodology depends on age, length of time since first detection of islet autoantibody, number of islet autoantibodies detected, and presence of symptoms of type 1 diabetes (see Table 1 and Tables 3–5). Ab, antibody; GP, general practitioner; PRN, pro re nata (as needed); Sx, symptoms; T1D, type 1 diabetes.

**Figure 2**
The continuum of educational needs and competencies: what does one need to know? The image represents the anticipated skills that must be developed within the continuum of stakeholders in monitoring presymptomatic type 1 diabetes. The groups indicated within the pyramid sections should have the competencies described and participate as appropriate. The need is for unified, consistent, globally applicable language at all levels. T1D, type 1 diabetes.

See this image and copyright information in PMC

References

1. Gorsuch AN, Spencer KM, Lister J, et al. Evidence for a long prediabetic period in type I (insulin-dependent) diabetes mellitus. Lancet 1981;2:1363–1365 - PubMed
1. Riley WJ, Atkinson MA, Schatz DA, Maclaren NK. Comparison of islet autoantibodies in ‘pre-diabetes’ and recommendations for screening. J Autoimmun 1990;3 Suppl 1:47–51 - PubMed
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Consensus Guidance for Monitoring Individuals With Islet Autoantibody-Positive Pre-Stage 3 Type 1 Diabetes

Affiliations

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

Authors

Affiliations

Erratum in

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Conflict of interest statement

Figures

References

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