Staging and Screening of Type 1 Diabetes

Type 1 Diabetes (T1D) is an autoimmune disease that results when proteins in the body called autoantibodies attack healthy cells in the pancreas and impact their ability to produce the insulin that is needed to regulate blood sugar. There are three stages of T1D, which range from being able to detect a single autoantibody pre-Stage 1 to symptomatic T1D in Stage 3. Today, most people are not diagnosed with T1D until they are in Stage 3 and may be experiencing symptoms and potential life-threatening complications with long term consequences, should there be an occurrence of diabetes ketoacidosis (DKA)¹. The American Diabetes Association (ADA) defines DKA as a serious condition caused by an overload of ketones in your blood that can lead to diabetic coma or even death².

By screening for autoantibodies, T1D can be detected before a person develops symptoms. Early identification, staging and monitoring have been shown to reduce the incidence of DKA at diagnosis of T1D, reduce rates of hospitalization, and may help provide an opportunity for T1D management before clinical onset^3,4,5,

Anyone with a family history of T1D is at a significantly increased risk for developing the condition, however a majority of people who develop T1D have no history in their family⁶. A simple blood test that screens for autoantibodies can be ordered online⁷ or through your doctor to help identify risk for T1D early.

If a T1D screening test comes back positive with 1 highly-specific autoantibody, or 2 autoantibodies, you can discuss potential management options with your healthcare provider and develop a monitoring plan to give you time to prepare for T1D, discuss potential treatment options, avoid DKA and prevent downstream complications that could potentially improve your overall disease trajectory^8,9,10.

Sanofi is working toward a brighter future where patients and doctors may be able to take a proactive approach in T1D management. To find out more about T1D screening, you can talk to your healthcare provider or visit resources like https://www.jdrf.org and https://www.type1tested.com.

References:

¹ Scheiner, G., Weiner, S., Kruger, D., Pettus, J. (2022). Screening for Type 1 Diabetes: Role of the Diabetes Care and Education Specialist. Accessed July 14, 2023 from https://journals.sagepub.com/doi/10.1177/2633559X221110216
² American Diabetes Association. Accessed July 14, 2023 from https://diabetes.org/diabetes/dka-ketoacidosis-ketones
³ Barker JM, Goehrig SH, Barriga K, et al; DAISY study. Clinical characteristics of children diagnosed with type 1 diabetes through intensive screening and follow-up. Diabetes Care. 2004;27(6):1399-1404.
⁴ Elding Larsson H, Vehik K, Bell R, et al. Reduced prevalence of diabetic ketoacidosis at diagnosis of type 1 diabetes in young children participating in longitudinal follow-up. Diabetes Care. 2011;34(11):2347-2353.
⁵ Raab J, Haupt F, Scholz M, et al; Fr1da Study Group. Capillary blood islet autoantibody screening for identifying pre-type 1 diabetes in the general population: design and initial results of the Fr1da study. BMJ Open. 2016;6(5):1-12.
⁶ American Diabetes Association. Learn the Genetics of Diabetes. Accessed July 14, 2023 from https://www.diabetes.org/diabetes/genetics-diabetes
⁷ Enable Biosciences. https://type1testing.enablebiosciences.com/order-form-2
⁸ Insel RA, Dunne JL, Atkinson MA, et al. Staging presymptomatic type 1 diabetes: a scientific statement of JDRF, the Endocrine Society, and the American Diabetes Association. Diabetes Care. 2015;38(10):1964-1974.
⁹ JDRF. Honeymoon Phase. Accessed December 8, 2022. https://www.jdrf.org/t1d-resources/about/honeymoon-phase
¹⁰ Xie Z, Chang C, Zhou Z. Molecular mechanisms in autoimmune type 1 diabetes: a critical review. Clin Rev Allergy Immunol. 2014;47(2):174-192

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