Top

Published in:

Open Access 01-01-2019 | Commentary

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

Author: Parth Narendran

Published in: Diabetologia | Issue 1/2019

Excerpt

On the 31 December 2014, 13-year-old Peter Baldwin from Cardiff, UK, was taken to his GP with symptoms of a worsening chest infection, thirst and tiredness. His blood glucose was not checked, new-onset type 1 diabetes was missed, and Peter subsequently went on to develop severe diabetic ketoacidosis (DKA). Despite the best efforts of paramedics and healthcare staff, Peter unfortunately did not get past the first few days of his type 1 diabetes and passed away soon after. A tragic loss to all that knew him, and of a promising young life [1]. …

BBC News. Peter Baldwin: type 1 diabetes test backed after boy’s death, 13 July 2018. Available from https://www.bbc.co.uk/news/uk-wales-44808388. Accessed 1 October 2018

RCPCH (2017) National Paediatric Diabetes Audit Report 2012–15. Part 2: Hospital admissions and complications. Royal College of Paediatrics and Child Health, London. Available at www.rcpch.ac.uk/sites/default/files/2018-03/npda_hospital_admissions_report_part_2_2012-15.pdf, accessed 26 October 2018

Duca LM, Wang B, Rewers M et al (2017) Diabetic ketoacidosis at diagnosis of type 1 diabetes predicts poor long-term glycemic control. Diabetes Care 40(9):1249–1255. https://doi.org/10.2337/dc17-0558 CrossRefPubMed

Lundgren M, Jonsdottir B, Elding Larsson H, DiPiS study group (2018) Effect of screening for type 1 diabetes on early metabolic control: the DiPiS study. Diabetologia. https://doi.org/10.1007/s00125-018-4706-z

DiMeglio LA, Evans-Molina C, Oram RA (2018) Type 1 diabetes. Lancet 391(10138):2449–2462. https://doi.org/10.1016/S0140-6736(18)31320-5 CrossRefPubMed

Bingley PJ (2010) Clinical applications of diabetes antibody testing. J Clin Endocrinol Metab 95(1):25–33. https://doi.org/10.1210/jc.2009-1365 CrossRefPubMed

Mehers KL, Gillespie KM (2008) The genetic basis for type 1 diabetes. Br Med Bull 88(1):115–129. https://doi.org/10.1093/bmb/ldn045 CrossRefPubMed

Jacobsen LM, Haller MJ, Schatz DA (2018) Understanding pre-type 1 diabetes: the key to prevention. Front Endocrinol (Lausanne) 9:70. https://doi.org/10.3389/fendo.2018.00070 CrossRef

Bingley PJ, Bonifacio E, Ziegler AG et al (2001) Proposed guidelines on screening for risk of type 1 diabetes. Diabetes Care 24(2):398. https://doi.org/10.2337/diacare.24.2.398 CrossRefPubMed

10.

Lundgren M, Sahlin Å, Svensson C et al (2014) Reduced morbidity at diagnosis and improved glycemic control in children previously enrolled in DiPiS follow-up. Pediatr Diabetes 15(7):494–501. https://doi.org/10.1111/pedi.12151 CrossRefPubMedPubMedCentral

11.

Elding Larsson H, Vehik K, Bell R et al (2011) Reduced prevalence of diabetic ketoacidosis at diagnosis of type 1 diabetes in young children participating in longitudinal follow-up. Diabetes Care 34(11):2347–2352. https://doi.org/10.2337/dc11-1026 CrossRefPubMedPubMedCentral

12.

Barker JM, Goehrig SH, Barriga K et al (2004) Clinical characteristics of children diagnosed with type 1 diabetes through intensive screening and follow-up. Diabetes Care 27(6):1399–1404. https://doi.org/10.2337/diacare.27.6.1399 CrossRefPubMed

13.

Steck AK, Larsson HE, Liu X et al (2017) Residual beta-cell function in diabetes children followed and diagnosed in the TEDDY study compared to community controls. Pediatr Diabetes 18(8):794–802. https://doi.org/10.1111/pedi.12485 CrossRefPubMedPubMedCentral

14.

Kupila A, Muona P, Simell T et al (2001) Feasibility of genetic and immuno-logical prediction of type I diabetes in a population-based birth cohort. Diabetologia 44(3):290–297. https://doi.org/10.1007/s001250051616 CrossRefPubMed

15.

Hekkala AM, Ilonen J, Toppari J et al (2018) Ketoacidosis at diagnosis of type 1 diabetes: effect of prospective studies with newborn genetic screening and follow up of risk children. Pediatr Diabetes 19(2):314–319. https://doi.org/10.1111/pedi.12541 CrossRefPubMed

16.

Nirantharakumar K, Mohammed N, Toulis KA et al (2018) Clinically meaningful and lasting HbA_1c improvement rarely occurs after 5 years of type 1 diabetes: an argument for early, targeted and aggressive intervention following diagnosis. Diabetologia 61(5):1064–1070. https://doi.org/10.1007/s00125-018-4574-6 CrossRefPubMed

17.

Bonifacio E, Mathieu C, Nepom GT et al (2017) Rebranding asymptomatic type 1 diabetes: the case for autoimmune beta cell disorder as a pathological and diagnostic entity. Diabetologia 60(1):35–38. https://doi.org/10.1007/s00125-016-4144-8 CrossRefPubMed

18.

Insel RA, Dunne JL, Atkinson MA et al (2015) Staging presymptomatic type 1 diabetes: a scientific statement of JDRF, the Endocrine Society, and the American Diabetes Association. Diabetes Care 38(10):1964–1974. https://doi.org/10.2337/dc15-1419 CrossRefPubMedPubMedCentral

19.

Wilson JMG, Jungner G (1968) Principles and practice of screening for disease. WHO, Geneva, Available from: http://www.who.int/bulletin/volumes/86/4/07-050112BP.pdf. Accessed 1 October 2018

20.

Barry E, Greenhalgh T, Fahy N (2018) How are health-related behaviours influenced by a diagnosis of pre-diabetes? A meta-narrative review. BMC Med 16(1):121. https://doi.org/10.1186/s12916-018-1107-6 CrossRefPubMedPubMedCentral

21.

Feltbower RG, Bodansky HJ, McKinney PA et al (2002) Trends in the incidence of childhood diabetes in south Asians and other children in Bradford, UK. Diabet Med 19(2):162–166. https://doi.org/10.1046/j.1464-5491.2002.00691.x CrossRefPubMed

22.

Shields BM, McDonald TJ, Oram R et al (2018) C-peptide decline in type 1 diabetes has two phases: an initial exponential fall and a subsequent stable phase. Diabetes Care 41(7):1486–1492. https://doi.org/10.2337/dc18-0465 CrossRefPubMedPubMedCentral

23.

Leete P, Willcox A, Krogvold L et al (2016) Differential insulitic profiles determine the extent of β-cell destruction and the age at onset of type 1 diabetes. Diabetes 65(5):1362–1369. https://doi.org/10.2337/db15-1615 CrossRefPubMed

24.

Insel RA, Dunne JL, Ziegler A-G (2015) General population screening for type 1 diabetes: has its time come? Curr Opin Endocrinol Diabetes Obes 22(4):270–276. https://doi.org/10.1097/MED.0000000000000173 CrossRefPubMed

25.

Diabetes UK. Do you know the 4 Ts of type 1 diabetes? Available from www.diabetes.org.uk/get_involved/campaigning/4-ts-campaign. Accessed 1 October 2018

26.

National Assembly for Wales. P-04-682 Routine screening for type 1 diabetes in children and young people. Available from www.senedd.assembly.wales/mgIssueHistoryHome.aspx?IId=14661. Accessed 1 October 2018

27.

Winkler C, Schober E, Ziegler A-G, Holl RW (2012) Markedly reduced rate of diabetic ketoacidosis at onset of type 1 diabetes in relatives screened for islet autoantibodies. Pediatr Diabetes 13(4):308–313. https://doi.org/10.1111/j.1399-5448.2011.00829.x CrossRefPubMed

Title: Screening for type 1 diabetes: are we nearly there yet?
Author: Parth Narendran
Publication date: 01-01-2019
Publisher: Springer Berlin Heidelberg
Published in: Diabetologia / Issue 1/2019
Print ISSN: 0012-186X
Electronic ISSN: 1432-0428
DOI: https://doi.org/10.1007/s00125-018-4774-0

Live Webinar | 27-06-2024 | 18:00 (CEST)

Keynote webinar | Spotlight on medication adherence

Reserve your place

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.

Prof. Kevin Dolgin

Prof. Florian Limbourg

Prof. Anoop Chauhan

Developed by: Springer Medicine

Obesity Clinical Trial Summary

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine

Highlights from the ACC 2024 Congress

Year in Review: Pediatric cardiology

Pediatric Cardiology Video

Watch Dr. Anne Marie Valente present the last year's highlights in pediatric and congenital heart disease in the official ACC.24 Year in Review session.

Year in Review: Pulmonary vascular disease

Cardiopulmonary Comorbidity Video

The last year's highlights in pulmonary vascular disease are presented by Dr. Jane Leopold in this official video from ACC.24.

Year in Review: Valvular heart disease

Valvular Heart Disease Video

Watch Prof. William Zoghbi present the last year's highlights in valvular heart disease from the official ACC.24 Year in Review session.

Year in Review: Heart failure and cardiomyopathies

Heart Failure Video

Watch this official video from ACC.24. Dr. Biykem Bozkurt discusses last year's major advances in heart failure and cardiomyopathies.

ACC 2024 Congress Coverage

Year in Review: Heart failure and cardiomyopathies

Heart Failure Video

Watch this official video from ACC.24. Dr. Biykem Bozkurt discusses last year's major advances in heart failure and cardiomyopathies.

Watch now

Semaglutide benefits people with type 2 diabetes and obesity-related heart failure

16-04-2024 Type 2 Diabetes News

Incentivised to exercise

11-04-2024 Lifestyle Modifications News

New intervention for STEMI-related cardiogenic shock

10-04-2024 Myocardial Infarction News

» View more highlights on the ACC 2024 congress hub page

Image Credits

Illustration of figure on mountain summit/© Orapun / Stock.adobe.com, STEP AAG HeroTeaserCollection image/© Tarek / Generated with AI / Stock.adobe.com, ACC 2024 Pediatric and Congenital Heart Disease: Year in Review/© 2024 American College of Cardiology, ACC 2024 Pulmonary Vascular Disease: Year in Review/© 2024 American College of Cardiology, ACC 2024 Valvular Heart Disease: Year in Review/© 2024 American College of Cardiology, ACC 2024 HF and Cardiomyopathies: Year in Review/© 2024 American College of Cardiology, Woman out walking/© Seventyfour / stock.adobe.com (symbolic image with model), Woman checking smartwatch /© saltdium / stock.adobe.com (symbolic image with model), Cardiac catheterization/© Damian / stock.adobe.com

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Excerpt

Please log in to get access to this content

Other articles of this Issue 1/2019

A cost analysis of intensified vs conventional multifactorial therapy in individuals with type 2 diabetes: a post hoc analysis of the Steno-2 study

Is there evidence for sex differences in the association between diabetes and cancer? Reply to Dankner R, Boker LK, Freedman LS [letter]

Beta cell function in type 1 diabetes determined from clinical and fasting biochemical variables

The deubiquitinating enzyme USP19 modulates adipogenesis and potentiates high-fat-diet-induced obesity and glucose intolerance in mice

Global trends in diabetes complications: a review of current evidence

Comment on ‘Exercise training decreases pancreatic fat content and improves beta cell function regardless of baseline glucose tolerance: a randomised controlled trial’

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

Highlights from the ACC 2024 Congress

ACC 2024 Congress Coverage