Latest Updates in Prevention and Screening of Type 1 Diabetes Mellitus.

Abstract

Purpose of review: We describe the latest guidelines for classification of stages of type 1 diabetes (T1D) and updates regarding screening and prevention of T1D in the pediatric population.

Recent findings: Preclinical diabetes is now staged and there are both completed and ongoing trials that have identified therapeutic targets to potentially delay the onset of clinical T1D and the need for insulin therapy. The approval of teplizumab as the first FDA approved pharmacologic agent to delay progression of T1D, makes screening increasingly important.

Summary: Type 1 diabetes (T1D) is a chronic disease caused by autoimmune destruction of pancreatic beta cells, resulting in insulin deficiency. Screening for T1D is offered in clinical trials for high-risk individuals, such as family members of those with T1D. Advantages to screening for T1D include prevention of life-threatening diabetic ketoacidosis (DKA) and reduction in the risk of associated morbidity and mortality. T1D is now classified in stages that are defined by the presence of pancreatic autoantibodies and dysglycemia. Teplizumab is a humanized anti-CD3 monoclonal antibody and is the first pharmacologic agent approved by the US Food and Drug Administration (FDA) to delay progression of T1D. Additionally, there have been many trials aimed at identifying additional therapeutic targets to delay onset of clinical T1D and the need for insulin therapy.