Diabetes mellitus type 1 screening: Difference between revisions
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==Overview== | ==Overview== | ||
According to the American Diabetic | According to the American Diabetic Association, [[screening]] for [[diabetes mellitus type 1]] is not recommended. Nevertheless, there are some data proposing favorable effects within [[screening|screened]] [[patient|patients]]. | ||
==Screening== | ==Screening== | ||
* According to the American diabetic association screening for type 1 | * According to the American diabetic association screening for [[diabetes mellitus type 1]] is not recommended. However, one should consider referring relatives of those with [[diabetes mellitus type 1|type 1 diabetes]] for [[antibody]] testing for risk assessment in the setting of a [http://www2 .diabetestrialnet.org clinical research study clincal study clinical research]. Higher-risk individuals may be tested, but only in the context of a clinical research setting.<ref name=":0" /> | ||
* Based on some studies, [[screening]] for [[diabetes mellitus type 1|diabetic]] [[patient|patients]] has some favorable effects. The following table is a summary of [[screening]] effects based on 6 pediatric studies:<ref name="pmid22060727">{{cite journal| author=Winkler C, Schober E, Ziegler AG, Holl RW| title=Markedly reduced rate of diabetic ketoacidosis at onset of type 1 diabetes in relatives screened for islet autoantibodies. | journal=Pediatr Diabetes | year= 2012 | volume= 13 | issue= 4 | pages= 308-13 | pmid=22060727 | doi=10.1111/j.1399-5448.2011.00829.x | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22060727 }} </ref><ref name="pmid21972409">{{cite journal| author=Elding Larsson H, Vehik K, Bell R, Dabelea D, Dolan L, Pihoker C | display-authors=etal| title=Reduced prevalence of diabetic ketoacidosis at diagnosis of type 1 diabetes in young children participating in longitudinal follow-up. | journal=Diabetes Care | year= 2011 | volume= 34 | issue= 11 | pages= 2347-52 | pmid=21972409 | doi=10.2337/dc11-1026 | pmc=3198296 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21972409 }} </ref><ref name="pmid24823816">{{cite journal| author=Lundgren M, Sahlin Å, Svensson C, Carlsson A, Cedervall E, Jönsson B | display-authors=etal| title=Reduced morbidity at diagnosis and improved glycemic control in children previously enrolled in DiPiS follow-up. | journal=Pediatr Diabetes | year= 2014 | volume= 15 | issue= 7 | pages= 494-501 | pmid=24823816 | doi=10.1111/pedi.12151 | pmc=4190091 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24823816 }} </ref><ref name="pmid28127835">{{cite journal| author=Steck AK, Larsson HE, Liu X, Veijola R, Toppari J, Hagopian WA | display-authors=etal| title=Residual beta-cell function in diabetes children followed and diagnosed in the TEDDY study compared to community controls. | journal=Pediatr Diabetes | year= 2017 | volume= 18 | issue= 8 | pages= 794-802 | pmid=28127835 | doi=10.1111/pedi.12485 | pmc=5529265 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=28127835 }} </ref><ref name="pmid11317658">{{cite journal| author=Kupila A, Muona P, Simell T, Arvilommi P, Savolainen H, Hämäläinen AM | display-authors=etal| title=Feasibility of genetic and immunological prediction of type I diabetes in a population-based birth cohort. | journal=Diabetologia | year= 2001 | volume= 44 | issue= 3 | pages= 290-7 | pmid=11317658 | doi=10.1007/s001250051616 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11317658 }} </ref><ref name="pmid28544185">{{cite journal| author=Hekkala AM, Ilonen J, Toppari J, Knip M, Veijola R| title=Ketoacidosis at diagnosis of type 1 diabetes: Effect of prospective studies with newborn genetic screening and follow up of risk children. | journal=Pediatr Diabetes | year= 2018 | volume= 19 | issue= 2 | pages= 314-319 | pmid=28544185 | doi=10.1111/pedi.12541 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=28544185 }} </ref> | * Based on some studies, [[screening]] for [[diabetes mellitus type 1|diabetic]] [[patient|patients]] has some favorable effects. The following table is a summary of [[screening]] effects based on 6 [[pediatrics|pediatric]] studies:<ref name="pmid22060727">{{cite journal| author=Winkler C, Schober E, Ziegler AG, Holl RW| title=Markedly reduced rate of diabetic ketoacidosis at onset of type 1 diabetes in relatives screened for islet autoantibodies. | journal=Pediatr Diabetes | year= 2012 | volume= 13 | issue= 4 | pages= 308-13 | pmid=22060727 | doi=10.1111/j.1399-5448.2011.00829.x | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22060727 }} </ref><ref name="pmid21972409">{{cite journal| author=Elding Larsson H, Vehik K, Bell R, Dabelea D, Dolan L, Pihoker C | display-authors=etal| title=Reduced prevalence of diabetic ketoacidosis at diagnosis of type 1 diabetes in young children participating in longitudinal follow-up. | journal=Diabetes Care | year= 2011 | volume= 34 | issue= 11 | pages= 2347-52 | pmid=21972409 | doi=10.2337/dc11-1026 | pmc=3198296 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21972409 }} </ref><ref name="pmid24823816">{{cite journal| author=Lundgren M, Sahlin Å, Svensson C, Carlsson A, Cedervall E, Jönsson B | display-authors=etal| title=Reduced morbidity at diagnosis and improved glycemic control in children previously enrolled in DiPiS follow-up. | journal=Pediatr Diabetes | year= 2014 | volume= 15 | issue= 7 | pages= 494-501 | pmid=24823816 | doi=10.1111/pedi.12151 | pmc=4190091 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24823816 }} </ref><ref name="pmid28127835">{{cite journal| author=Steck AK, Larsson HE, Liu X, Veijola R, Toppari J, Hagopian WA | display-authors=etal| title=Residual beta-cell function in diabetes children followed and diagnosed in the TEDDY study compared to community controls. | journal=Pediatr Diabetes | year= 2017 | volume= 18 | issue= 8 | pages= 794-802 | pmid=28127835 | doi=10.1111/pedi.12485 | pmc=5529265 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=28127835 }} </ref><ref name="pmid11317658">{{cite journal| author=Kupila A, Muona P, Simell T, Arvilommi P, Savolainen H, Hämäläinen AM | display-authors=etal| title=Feasibility of genetic and immunological prediction of type I diabetes in a population-based birth cohort. | journal=Diabetologia | year= 2001 | volume= 44 | issue= 3 | pages= 290-7 | pmid=11317658 | doi=10.1007/s001250051616 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11317658 }} </ref><ref name="pmid28544185">{{cite journal| author=Hekkala AM, Ilonen J, Toppari J, Knip M, Veijola R| title=Ketoacidosis at diagnosis of type 1 diabetes: Effect of prospective studies with newborn genetic screening and follow up of risk children. | journal=Pediatr Diabetes | year= 2018 | volume= 19 | issue= 2 | pages= 314-319 | pmid=28544185 | doi=10.1111/pedi.12541 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=28544185 }} </ref> | ||
{| class="wikitable" | {| class="wikitable" | ||
!Study | !Study | ||
!'''Less DKA''' | !'''Less [[Diabetic ketoacidosis|DKA]]''' | ||
!'''Lower HbA1c''' | !'''Lower [[Glycosylated hemoglobin|HbA1c]]''' | ||
!'''Lower insulin dose''' | !'''Lower [[insulin]] [[dose]]''' | ||
!'''Shorter hospitalization period''' | !'''Shorter [[Hospital|hospitalization]] period''' | ||
|- | |- | ||
|BABYDIAB and Munich | |BABYDIAB and Munich | ||
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<sub><big> *TEDDY (The Environmental Determinants of [[Diabetes]] in the Young) study reported higher [[c-peptide]] level at least within 12 months after [[diagnosis]], which is related to better response to [[immunology|immunologic]] interventions</big>.<ref name="pmid28127835">{{cite journal| author=Steck AK, Larsson HE, Liu X, Veijola R, Toppari J, Hagopian WA | display-authors=etal| title=Residual beta-cell function in diabetes children followed and diagnosed in the TEDDY study compared to community controls. | journal=Pediatr Diabetes | year= 2017 | volume= 18 | issue= 8 | pages= 794-802 | pmid=28127835 | doi=10.1111/pedi.12485 | pmc=5529265 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=28127835 }}</ref></big></sub> | <sub><big> *TEDDY (The Environmental Determinants of [[Diabetes]] in the Young) study reported higher [[c-peptide]] level at least within 12 months after [[diagnosis]], which is related to better response to [[immunology|immunologic]] interventions</big>.<ref name="pmid28127835">{{cite journal| author=Steck AK, Larsson HE, Liu X, Veijola R, Toppari J, Hagopian WA | display-authors=etal| title=Residual beta-cell function in diabetes children followed and diagnosed in the TEDDY study compared to community controls. | journal=Pediatr Diabetes | year= 2017 | volume= 18 | issue= 8 | pages= 794-802 | pmid=28127835 | doi=10.1111/pedi.12485 | pmc=5529265 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=28127835 }}</ref></big></sub> | ||
<sub><big> *DIPP (Finnish [[Type 1 diabetes]] Prediction and [[Prevention (medical)|Prevention]]) reported lower rate of [[weight loss]] among [[patient|patients]] who were screened for [[diabetes mellitus type 1]]<ref name="pmid30426167">{{cite journal| author=Narendran P| title=Screening for type 1 diabetes: are we nearly there yet? | journal=Diabetologia | year= 2019 | volume= 62 | issue= 1 | pages= 24-27 | pmid=30426167 | doi=10.1007/s00125-018-4774-0 | pmc=6290651 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=30426167 }} </ref></big></sub> | <sub><big> *DIPP (Finnish [[Type 1 diabetes]] Prediction and [[Prevention (medical)|Prevention]]) reported lower rate of [[weight loss]] among [[patient|patients]] who were [[screening|screened]] for [[diabetes mellitus type 1]]<ref name="pmid30426167">{{cite journal| author=Narendran P| title=Screening for type 1 diabetes: are we nearly there yet? | journal=Diabetologia | year= 2019 | volume= 62 | issue= 1 | pages= 24-27 | pmid=30426167 | doi=10.1007/s00125-018-4774-0 | pmc=6290651 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=30426167 }} </ref></big></sub> | ||
Revision as of 18:33, 11 September 2020
Diabetes mellitus type 1 Microchapters |
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Vishal Devarkonda, M.B.B.S[2]
Overview
According to the American Diabetic Association, screening for diabetes mellitus type 1 is not recommended. Nevertheless, there are some data proposing favorable effects within screened patients.
Screening
- According to the American diabetic association screening for diabetes mellitus type 1 is not recommended. However, one should consider referring relatives of those with type 1 diabetes for antibody testing for risk assessment in the setting of a clinical research. Higher-risk individuals may be tested, but only in the context of a clinical research setting.[1]
- Based on some studies, screening for diabetic patients has some favorable effects. The following table is a summary of screening effects based on 6 pediatric studies:[2][3][4][5][6][7]
Study | Less DKA | Lower HbA1c | Lower insulin dose | Shorter hospitalization period |
---|---|---|---|---|
BABYDIAB and Munich | + | + | - | + |
DiPiS | + | + | - | Not determined |
TEDDY | + | + | + | Not determined |
DAISY | + | + | + | + |
DIPP | + | + | Not determined | Not determined |
*TEDDY (The Environmental Determinants of Diabetes in the Young) study reported higher c-peptide level at least within 12 months after diagnosis, which is related to better response to immunologic interventions.[5]
*DIPP (Finnish Type 1 diabetes Prediction and Prevention) reported lower rate of weight loss among patients who were screened for diabetes mellitus type 1[8]
References
- ↑
- ↑ Winkler C, Schober E, Ziegler AG, 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): 308–13. doi:10.1111/j.1399-5448.2011.00829.x. PMID 22060727.
- ↑ Elding Larsson H, Vehik K, Bell R, Dabelea D, Dolan L, Pihoker C; 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): 2347–52. doi:10.2337/dc11-1026. PMC 3198296. PMID 21972409.
- ↑ Lundgren M, Sahlin Å, Svensson C, Carlsson A, Cedervall E, Jönsson B; 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. doi:10.1111/pedi.12151. PMC 4190091. PMID 24823816.
- ↑ 5.0 5.1 Steck AK, Larsson HE, Liu X, Veijola R, Toppari J, Hagopian WA; 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. doi:10.1111/pedi.12485. PMC 5529265. PMID 28127835.
- ↑ Kupila A, Muona P, Simell T, Arvilommi P, Savolainen H, Hämäläinen AM; et al. (2001). "Feasibility of genetic and immunological prediction of type I diabetes in a population-based birth cohort". Diabetologia. 44 (3): 290–7. doi:10.1007/s001250051616. PMID 11317658.
- ↑ Hekkala AM, Ilonen J, Toppari J, Knip M, Veijola R (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. doi:10.1111/pedi.12541. PMID 28544185.
- ↑ Narendran P (2019). "Screening for type 1 diabetes: are we nearly there yet?". Diabetologia. 62 (1): 24–27. doi:10.1007/s00125-018-4774-0. PMC 6290651. PMID 30426167.