Autoantibody Test for Type 1 Diabetes in Children: Are There Reasons to Implement a Screening Program in the General Population? A Statement Endorsed by the Italian Society for Paediatric Endocrinology and Diabetes (SIEDP-ISPED) and the Italian...

Overview

Journal Ital J Pediatr

Publisher Biomed Central

Specialty Pediatrics

Date 2023 Jul 19

PMID 37468976

Authors

Valentino Cherubini

Francesco Chiarelli

Affiliations

Soon will be listed here.

Abstract

In recent years screening of type 1 diabetes (T1D) in both at risk children and general population has been widely discussed with the aim of increasing awareness of the importance to early detect (and possibly treat) at-risk children in early stages of the chronic autoimmune progression to T1D.In fact, it is well known that first-degree relatives have the highest risk of T1D, but up to 90% of children who develop T1D do not have a family history and belong to the general population.The reasons for screening children well before the clinical onset of T1D include prevention of DKA (still up to 60% children are diagnosed with DKA) and related morbidities and mortality, reducing the need for hospitalisation, time to provide emotional support and education to ensure a smooth transition to insulin treatment, and opportunities for new treatments to prevent or delay progression.There are pros and cons of screening of T1D in children, but recent evidences suggest that it is now time to consider possible a screening for T1D in children.Recently, the European Society for Paediatric Endocrinology (ESPE) has endorsed a Position Statement, discussing the pros and cons of screening for T1D in the general population; ESPE supports national Societies for Paediatric Endocrinology to spread information on this important issue in various countries throughout Europe; the Italian Society for Paediatric Endocrinology and Diabetes (SIEDP-ISPED) and the Italian Society of Paediatrics (SIP) endorse this document with the specific aim of increasing awareness on screening for paediatric T1D in the general population.

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References

Ziegler A, Rewers M, Simell O, Simell T, Lempainen J, Steck A . Seroconversion to multiple islet autoantibodies and risk of progression to diabetes in children. JAMA. 2013; 309(23):2473-9. PMC: 4878912. DOI: 10.1001/jama.2013.6285. View

. 13. Children and Adolescents: . Diabetes Care. 2019; 43(Suppl 1):S163-S182. DOI: 10.2337/dc20-S013. View

Dhatariya K, Glaser N, Codner E, Umpierrez G . Diabetic ketoacidosis. Nat Rev Dis Primers. 2020; 6(1):40. DOI: 10.1038/s41572-020-0165-1. View

Meehan C, Fout B, Ashcraft J, Schatz D, Haller M . Screening for T1D risk to reduce DKA is not economically viable. Pediatr Diabetes. 2015; 16(8):565-72. DOI: 10.1111/pedi.12313. View

Ziegler A, Kick K, Bonifacio E, Haupt F, Hippich M, Dunstheimer D . Yield of a Public Health Screening of Children for Islet Autoantibodies in Bavaria, Germany. JAMA. 2020; 323(4):339-351. PMC: 6990943. DOI: 10.1001/jama.2019.21565. View

Prigge R, McKnight J, Wild S, Haynes A, Jones T, Davis E . International comparison of glycaemic control in people with type 1 diabetes: an update and extension. Diabet Med. 2021; 39(5):e14766. DOI: 10.1111/dme.14766. View

Hummel M, Ziegler A, Roth R . Psychological impact of childhood islet autoantibody testing in families participating in the BABYDIAB study. Diabet Med. 2004; 21(4):324-8. DOI: 10.1111/j.1464-5491.2004.01142.x. View

Angus V, Waugh N . Hospital admission patterns subsequent to diagnosis of type 1 diabetes in children : a systematic review. BMC Health Serv Res. 2007; 7:199. PMC: 2233617. DOI: 10.1186/1472-6963-7-199. View

Maahs D, Hermann J, Holman N, Foster N, Kapellen T, Allgrove J . Rates of diabetic ketoacidosis: international comparison with 49,859 pediatric patients with type 1 diabetes from England, Wales, the U.S., Austria, and Germany. Diabetes Care. 2015; 38(10):1876-82. DOI: 10.2337/dc15-0780. View

10.

Cryer P . Mechanisms of hypoglycemia-associated autonomic failure in diabetes. N Engl J Med. 2013; 369(4):362-72. DOI: 10.1056/NEJMra1215228. View

11.

Herold K, Bundy B, Long S, Bluestone J, DiMeglio L, Dufort M . An Anti-CD3 Antibody, Teplizumab, in Relatives at Risk for Type 1 Diabetes. N Engl J Med. 2019; 381(7):603-613. PMC: 6776880. DOI: 10.1056/NEJMoa1902226. View

12.

Cherubini V, Marino M, Carle F, Zagaroli L, Bowers R, Gesuita R . Effectiveness of ketoacidosis prevention campaigns at diagnosis of type 1 diabetes in children: A systematic review and meta-analysis. Diabetes Res Clin Pract. 2021; 175:108838. DOI: 10.1016/j.diabres.2021.108838. View

13.

Sussman M, Benner J, Haller M, Rewers M, Griffiths R . Estimated Lifetime Economic Burden of Type 1 Diabetes. Diabetes Technol Ther. 2019; 22(2):121-130. DOI: 10.1089/dia.2019.0398. View

14.

Cherubini V, Gesuita R, Bonfanti R, Franzese A, Frongia A, Iafusco D . Health-related quality of life and treatment preferences in adolescents with type 1 diabetes. The VIPKIDS study. Acta Diabetol. 2013; 51(1):43-51. DOI: 10.1007/s00592-013-0466-x. View

15.

Reynolds K, Helgeson V . Children with diabetes compared to peers: depressed? Distressed? A meta-analytic review. Ann Behav Med. 2011; 42(1):29-41. PMC: 3140576. DOI: 10.1007/s12160-011-9262-4. View

16.

Aye T, Mazaika P, Mauras N, Marzelli M, Shen H, Hershey T . Impact of Early Diabetic Ketoacidosis on the Developing Brain. Diabetes Care. 2018; 42(3):443-449. PMC: 6385695. DOI: 10.2337/dc18-1405. View

17.

Wilhelm-Benartzi C, Miller S, Bruggraber S, Picton D, Wilson M, Gatley K . Study protocol: Minimum effective low dose: anti-human thymocyte globulin (MELD-ATG): phase II, dose ranging, efficacy study of antithymocyte globulin (ATG) within 6 weeks of diagnosis of type 1 diabetes. BMJ Open. 2021; 11(12):e053669. PMC: 8655536. DOI: 10.1136/bmjopen-2021-053669. View

18.

Markowitz J, Volkening L, Butler D, Antisdel-Lomaglio J, Anderson B, Laffel L . Re-examining a measure of diabetes-related burden in parents of young people with Type 1 diabetes: the Problem Areas in Diabetes Survey - Parent Revised version (PAID-PR). Diabet Med. 2011; 29(4):526-30. PMC: 3510480. DOI: 10.1111/j.1464-5491.2011.03434.x. View

19.

Samuelsson U, Steineck I, Gubbjornsdottir S . A high mean-HbA1c value 3-15 months after diagnosis of type 1 diabetes in childhood is related to metabolic control, macroalbuminuria, and retinopathy in early adulthood--a pilot study using two nation-wide population based quality registries. Pediatr Diabetes. 2013; 15(3):229-35. DOI: 10.1111/pedi.12085. View

20.

Chiarelli F, Rewers M, Phillip M . Screening of Islet Autoantibodies for Children in the General Population: A Position Statement Endorsed by the European Society for Paediatric Endocrinology. Horm Res Paediatr. 2022; 95(4):393-396. DOI: 10.1159/000525824. View