Diabetes Dialogue: New Early-Stage T1D Monitoring Guidance, with Anastasia Albanese-O'Neill, PhD, APRN

Less than a month after rebranding from JDRF to Breakthrough T1D, the leading type 1 diabetes advocacy organization has now released new consensus guidance related to the monitoring of early-stage type 1 diabetes.

Debuted on the final day of the 84th American Diabetes Association Scientific Sessions, the consensus document seeks to fill a gap in guidance around autoantibody-positive individuals in early-stage type 1 diabetes as the community develops new means to delay or prevent progression of the disease. Proof of the document’s significance, it has received endorsement from both the ADA and the European Association for the Study of Diabetes, with simultaneous publication in Diabetes Care and Diabetologia.

“We are experiencing a paradigm shift in type 1 diabetes care, and we can now identify people in the earlier, presymptomatic stages of type 1 diabetes, before insulin is required, and intervene,” said Anastasia Albanese-O’Neill, PhD, APRN, associate vice president of Breakthrough T1D. “Until now, there was no consensus on how to care for these individuals in the clinical setting and provide appropriate education and psychological support. This new guidance should be used widely by healthcare providers to inform and guide the care of individuals in early stage T1D.”

Presented in a special symposium dedicated to the new consensus guidance, the document clocks in at 29 pages in length and cites more than 170 references. Included within the guidance are specific sections dedicated to monitoring among children and adolescents, adult patients, and pregnant patients. Beyond guidance on monitoring, the document also dedicates space to outlining updated terminology on type 1 diabetes staging and how to provide psychosocial and educational support for affected individuals and families.

“Early screening and risk monitoring has become critical in the care and delay of type 1 diabetes, to reduce the risk of complications with the disease such as diabetic ketoacidosis,” said Robert Gabbay, MD, PhD, chief scientific and medical officer of the ADA.

To learn more about this new guidance and discuss the future of type 1 diabetes, hosts of Diabetes Dialogue: Technology, Therapeutics, & Real-World Perspectives, Diana Isaacs, PharmD, an endocrine clinical pharmacist, director of Education and Training in Diabetes Technology, and codirector of Endocrine Disorders in Pregnancy at the Cleveland Clinic, and Natalie Bellini, DNP, program director of Diabetes Technology at University Hospitals Diabetes and Metabolic Care Center, sat down with Albanese-O’Neill at ADA 2024. During their conversation, hosts discuss the recent name change to Breakthrough T1D, the growing prevalence of adults being diagnosed with type 1 diabetes, and major takeaways from the consensus guidance.

Relevant disclosures for Albanese-O’Neill include Breakthrough T1D. Relevant disclosures for Dr. Bellini include Abbott Diabetes Care, MannKind, Provention Bio, and others. Relevant disclosures for Dr. Pantalone include Novo Nordisk, AstraZeneca, Bayer Inc., Corcept Therapeutics, Diasome, Eli Lilly and Company, Sanofi, and others. Dr Rodriguez has no disclosures.

References:

1. ^{Phillip M, Achenbach P, Addala A, et al. Consensus guidance for monitoring individuals with islet autoantibody-positive pre-stage 3 type 1 diabetes. Diabetologia. Published online June 24, 2024. doi:10.1007/s00125-024-06205-5}
2. ^{American Diabetes Association. American Diabetes Association showcases innovations and guidance for early risk monitoring of type 1 diabetes. American Diabetes Association Newsroom. June 24, 2024. Accessed June 24, 2024. https://diabetes.org/newsroom/press-releases/american-diabetes-association-showcases-innovations-and-guidance-early-risk.}