Monitoring of Presymptomatic Type 1 Diabetes

Learning Objectives

• Educate on the process and benefits of monitoring in people identified with presymptomatic T1D

Summary

When an individual is screened positive for presymptomatic type 1 diabetes, the next step within a rather short time frame is to take another confirmatory sample to see that this is true, that islet autoantibodies are there, and at the same time, start glucose metabolism monitoring. For example, by measuring hemoglobin A1c level or random plasma glucose level.

There are other methods, a very modern one is continuous glucose monitoring where you monitor the tissue glucose level for a period of 10 to 14 days, and that method gives a lot of information about glucose level variation in the tissue level, which correlates very well with plasma glucose. Then we have an overall glucose tolerance test that is a very informative method and can distinguish whether the individual has Stage 1 or Stage 2 type 1 diabetes. That test takes two hours, but it is doable even in some young children. As the information content is so high, it is still a valuable method to be performed as a tool of monitoring.

And of course, these methods must be discussed with the individual or the family and then agreed on how to perform these. It’s very important to monitor people who are positive for autoantibodies because you can prevent diagnosis of ketoacidosis. You can follow them to help families to prevent a diagnosis with complications and admission into hospital. The follow-up is very, very important. When people are diagnosed with prediabetes, in other words, that they are antibody positive, it's normal to be anxious about that. But it's helpful to encourage them to know what to do and what to look out for. The key point that they need to know is the symptoms of type 1 diabetes, so they will never get help too late.

MAT-GLB-2405117-1.0 – 08/2024