Abstract
Most screening programs to identify individuals at risk for type 1 diabetes have targeted relatives of people living with the disease to improve yield and feasibility. However, ∼90% of those who develop type 1 diabetes do not have a family history. Recent successes in disease-modifying therapies to impact the course of early-stage disease have ignited the consideration of the need for and feasibility of population screening to identify those at increased risk. Existing population screening programs rely on genetic or autoantibody screening, and these have yielded significant information about disease progression and approaches for timing for screening in clinical practice. At the March 2021 Type 1 Diabetes TrialNet Steering Committee meeting, a session was held in which ongoing efforts for screening in the general population were discussed. This report reviews the background of these efforts and the details of those programs. Additionally, we present hurdles that need to be addressed for successful implementation of population screening and provide initial recommendations for individuals with positive screens so that standardized guidelines for monitoring and follow-up can be established.
| Original language | English |
|---|---|
| Pages (from-to) | 610–623 |
| Number of pages | 14 |
| Journal | Diabetes |
| Volume | 71 |
| Issue number | 4 |
| Early online date | 22 Mar 2022 |
| DOIs | |
| Publication status | Published - 1 Apr 2022 |
Bibliographical note
Written for the NIDDK Type 1 Diabetes TrialNet Study GroupFunding Information:
Acknowledgments. S.S.R. acknowledges the assistance of Kristin A. Guertin, Department of Public Health Sciences, and David R. Repaske and Julia F. Taylor, Department of Pediatrics, University of Virginia. Funding. This work was funded in part by National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) (U01DK106993). The Type 1 Diabetes TrialNet Study Group is a clinical trials network funded through a cooperative agreement by the National Institutes of Health through the NIDDK, the National Institute of Allergy and Infectious Diseases, and the Eunice Kennedy Shriver National Institute of Child Health and Human Development, and JDRF. Duality of Interest. E.K.S. and M.R. received compensation from Med-scape for a continuing medical education event focused on general population screening. M.R. has consulted for Provention Bio and Janssen Research & Development. R.E.J.B. received speaking honoraria from Springer Healthcare and Eli Lilly and reports sitting on the Novo Nordisk UK Foundation Research Selection Committee on a voluntary basis. C.D. has served on advisory boards for Proven-tion Bio, Quell Therapeutics, and Viela Bio. K.C.H. has consulted for Provention Bio, Viela Bio, and Merck; is on the scientific advisory board for Nextimmune; is named as a co-inventor on a patent application to use teplizumab for delay of type 1 diabetes; and was the principle investigator on a trial of AG019 (Precigen) in the U.S. K.C.H. is also a co-inventor on a patent for delay or prevention of T1D with teplizumab but has assigned all rights. No other potential conflicts of interest relevant to this article were reported.
Publisher Copyright:
© 2022 by the American Diabetes Association.
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This is the accepted author manuscript (AAM). The final published version (version of record) is available online via American Diabetes Association at https://doi.org/10.2337/dbi20-0054. Please refer to any applicable terms of use of the publisher.