Advances in the Delayed Onset of Type 1 Diabetes

This activity is designed to meet the educational needs of Pediatric Endocrinologists, Adult Endocrinologists, Pediatricians, Primary Care Providers (PCPs), and Endocrine Nurses.

Launch Date: August 30, 2024

Expiration Date: August 29, 2025

1. Describe the clinical presentation of T1D in adults compared to children
2. Identify appropriate autoantibody screening strategies for T1D, including type, frequency, and number
3. Interpret results from screening protocols to drive management decisions
4. Discuss the latest clinical evidence for efficacy and tolerability of newly approved and investigational immunomodulatory agents
5. Implement strategies for appropriate clinical monitoring and early screening in individuals at highest risk

How to obtain CE Credit:

Please note, you have to watch the entire video in order to receive any CE credit for this online activity.

Click the Tests tile > Launch Video to view the module (create an IUH account if you don't already have one).

Credit will be awarded 30 days post completion.

References:

American Diabetes Association Professional Practice Committee. 2. Diagnosis and classification of diabetes: Standards of care in diabetes—2024. Diabetes Care. 2024;47(suppl 1):S20-S42. https://diabetesjournals.org/care/article/47/Supplement_1/S20/153954

American Diabetes Association Professional Practice Committee. 3. Prevention or delay of diabetes and associated comorbidities: Standards of care in diabetes—2024. Diabetes Care. 2024;47(suppl 1):S43-S51. https://diabetesjournals.org/care/article/47/Supplement_1/S43/153945

Besser REJ, Bell KJ, Couper JJ, et al. ISPAD Clinical Practice Consensus Guidelines 2022: Stages of type 1 diabetes in children and adolescents. Pediatr Diabetes. 2022;23:1175-1187. https://cdn.ymaws.com/www.ispad.org/resource/resmgr/consensus_guidelines_2018_/guidelines2022/ch._2_pediatric_diabetes_-_2.pdf

Mehta S, Ryabets-Lienhard A, Patel N, et al. Pediatric Endocrine Society statement on considerations for the use of teplizumab in clinical practice. Horm Res Paediatr. 2024;Apr 30:1-12. https://pubmed.ncbi.nlm.nih.gov/38663372/

Philip M, Achenbach P, Addala A, et al. Consensus guidance for monitoring individuals with islet autoantibody-positive pre-stage 3 type 1 diabetes. Diabetes Care. 2024;Jun 24:dci240042. https://pubmed.ncbi.nlm.nih.gov/38912694/

Atkinson MA, Mirmira RG. The pathogenic "symphony" in type 1 diabetes: A disorder of the immune system, β cells, and exocrine pancreas. Cell Metab. 2023;35:1500-1518. https://pubmed.ncbi.nlm.nih.gov/37478842/

Bogun MM, Bundy BN, Goland RS, Greenbaum CJ. C-peptide levels in subjects followed longitudinally before and after type 1 diabetes diagnosis in TrialNet. Diabetes Care. 2020;43:1836-1842. https://pubmed.ncbi.nlm.nih.gov/32457058/

Fyvie MJ, Gillespie KM. The importance of biomarker development for monitoring type 1 diabetes progression rate and therapeutic responsiveness. Front Immunol. 2023;14:1158278. https://pubmed.ncbi.nlm.nih.gov/37256143/

Herold KC, Bundy BN, Long SA, et al. An anti-CD3 antibody, teplizumab, in relatives at risk for type 1 diabetes. N Engl J Med. 2019;381:603-613. https://pubmed.ncbi.nlm.nih.gov/31180194/

Herold KC, Gitelman SE, Gottlieb PA, et al. Teplizumab: A disease-modifying therapy for type 1 diabetes that preserves β-Cell function. Diabetes Care. 2023;46:1848-1856. https://pubmed.ncbi.nlm.nih.gov/37607392/

Holt RIG, DeVries JH, Hess-Fischl A, et al. The management of type 1 diabetes in adults. A consensus report by the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD). Diabetes Care. 2021;44:2589-2625. https://pubmed.ncbi.nlm.nih.gov/34593612/

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;38:1964-1974. https://pubmed.ncbi.nlm.nih.gov/26404926/

Katsarou A, Gudbjörnsdottir S, Rawshani A, et al. Type 1 diabetes mellitus. Nat Rev Dis Primers. 2017;3:17016. https://pubmed.ncbi.nlm.nih.gov/28358037/

Leslie RD, Evans-Molina C, Freund-Brown J, et al. Adult-onset type 1 diabetes: Current understanding and challenges. Diabetes Care. 2021;44:2449-2456. https://pubmed.ncbi.nlm.nih.gov/34670785/

Linsley PS, Greenbaum CJ, Nepom GT. Uncovering pathways to personalized therapies in type 1 diabetes. Diabetes. 2021;70:831-841. https://pubmed.ncbi.nlm.nih.gov/33741606/

O'Donnell HK, Rasmussen CG, Dong F, et al. Anxiety and risk perception in parents of children identified by population screening as high risk for type 1 diabetes. Diabetes Care. 2023;46:2155-2161. https://pubmed.ncbi.nlm.nih.gov/37673098/

Ospelt E, Hardison H, Rioles N, et al. Understanding providers' readiness and attitudes toward autoantibody screening: A mixed-methods study. Clin Diabetes. 2024;42:17-26. https://pubmed.ncbi.nlm.nih.gov/38230325/

Ramos EL, Dayan CM, Chatenoud L, et al. Teplizumab and β-Cell function in newly diagnosed type 1 diabetes. N Engl J Med. 2023;389:2151-2161. https://pubmed.ncbi.nlm.nih.gov/37861217/

Simmons KM, Sims EK. Screening and prevention of type 1 diabetes: Where are we? J Clin Endocrinol Metab. 2023;108:3067-3079. https://pubmed.ncbi.nlm.nih.gov/37290044/

Simmons KMW, Frohnert BI, O'Donnell HK, et al. Historical insights and current perspectives on the diagnosis and management of presymptomatic type 1 diabetes. Diabetes Technol Ther. 2023;25:790-799. https://pubmed.ncbi.nlm.nih.gov/37695674/

Sims EK, Besser REJ, Dayan C, et al. Screening for type 1 diabetes in the general population: A status report and perspective. Diabetes. 2022;71:610-623. https://pubmed.ncbi.nlm.nih.gov/35316839/

Sims EK, Bundy BN, Stier K, et al. Teplizumab improves and stabilizes beta cell function in antibody-positive high-risk individuals. Sci Transl Med. 2021;13:eabc8980. https://pubmed.ncbi.nlm.nih.gov/33658358/

Smigoc Schweiger D. Recent advances in immune-based therapies for type 1 diabetes. Horm Res Paediatr. 2023;96:631-645. https://pubmed.ncbi.nlm.nih.gov/35533645/

VanBuecken D, Lord S, Greenbaum CJ. Changing the course of disease in type 1 diabetes. In: Feingold KR, Anawalt B, Blackman MR, eds. Endotext [Internet]. MDText.com; January 6, 2022. https://www.ncbi.nlm.nih.gov/books/NBK326738/

American Diabetes Association®. Summary of the American Diabetes Association® Type 1 Diabetes Screening & Awareness Roundtable. December 15, 2023. https://diabetes.org/sites/default/files/2024-04/ADA-T1D-Screening-and-Awareness-Roundtable-Report.pdf

ASK (Autoimmunity Screening for Kids). T1D screening program. https://www.askhealth.org/

Breakthrough T1D. Enrolling in Clinical Trials. https://www.breakthrought1d.org/clinical-trials/

Breakthrough T1D. Breakthrough T1D Early detection. https://www.breakthrought1d.org/early-detection/

CASCADE Research Study. Type 1 diabetes and celiac disease screening for children in the state of Washington. https://cascadekids.org/

Sanford Research. PLEDGE Pediatric Screening Program. https://research.sanfordhealth.org/fields-of-research/diabetes/pledge

Type 1 Diabetes TrialNet. For Healthcare Providers: TrialNet Recommendations for Clinicians. https://www.trialnet.org/healthcare-providers

Type 1 Diabetes TrialNet. Resources for T1D screening & national T1D screening program. https://www.trialnet.org/

University of Colorado – Barbara Davis Center for Diabetes. Ask the experts for early T1D answers and guidance. https://www.asktheexperts.org/

All URLs accessed June 24, 2024

For questions about accessibility or to request accommodations please contact the IUSM CME office at 317-274-0104 or [email protected]. One week advance notice will allow us to provide seamless access. Please ensure to specify the accommodations you need in order to participate.

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