Introduction and Objective: Type 1 diabetes (T1D) is a lifelong disorder caused by autoimmune destruction of pancreatic beta cells. A new paradigm shift in diagnosis of T1D provides an opportunity to identify individuals with early stage T1D, reduce diabetic ketoacidosis at diagnosis, and delay insulin dependence. A clinical implementation program, T1Detect, was initiated in a pediatric endocrinology clinic to identify individuals with early stage T1D with a personal or family history of autoimmune disorders. Methods: Wayne Pediatrics partnered with Breakthrough T1D to launch T1Detect in November 2024. Individuals were identified through in-clinic screening, community awareness events, and flyers to local physicians. Blood collection kits from Enable Biosciences were used to screen for islet autoantibodies (IAb), and confirmatory testing was performed at a local reference laboratory Results: 182 individuals were screened, of which 52.7% were adults, 56% Black, and 23.1% White. IAbs were detected in 6.6% of individuals screened (5 children, 7 adults). Four children completed confirmatory testing; two children had two positive IAbs and normal HbA1c consistent with stage 1 T1D, one child had a single positive IAb, and one child had no IAb. All three children with confirmed IAbs have a personal history of autoimmune thyroid disease and a family history of autoimmune diseases. All adults with single IAb on screening have not completed confirmatory testing. Conclusion: This T1Detect program has successfully identified individuals with early stage T1D who will need ongoing metabolic monitoring for progression, but additional education is required to improve follow-up of all positive screening results. Disclosure C. Buggs-Saxton: None. J. Lally: None. I.M. Ismaeil: None. A. Delauder: None. Funding Breakthrough T1D and the Jewish Fund
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