2024 Clinical Practice Consensus Guidelines

The 2024 update to the ISPAD Screening, Staging, and Strategies to Preserve Beta-Cell Function chapter introduces several new recommendations. This edition includes an evidence-based summary of recommendations for screening individuals at risk of Type 1 Diabetes (T1D) and monitoring those in the early stages of the disease. The targeted populations for screening include children and adolescents who have a family history of T1D, those who have tested positive for islet autoantibodies, and individuals with genetic markers associated with increased risk of T1D. The guidelines recommend that these high-risk groups undergo regular screening to detect early signs of beta-cell dysfunction and autoimmunity. Furthermore, the chapter highlights the need for tailored screening approaches that consider the unique needs of different populations, including those from diverse ethnic backgrounds and varying socioeconomic statuses. By identifying at-risk individuals early, healthcare providers can implement strategies to delay disease progression and preserve beta-cell function, ultimately improving long-term outcomes for those with T1D. The chapter also reviews clinical trials aimed at delaying the progression to Stage 3 T1D and preserving beta-cell function in those already at this stage 3. Notably, the chapter discusses the implications of the recent FDA approval of teplizumab, an immunotherapy designed to delay the progression from Stage 2 to Stage 3 T1D. Additionally, the guidelines emphasize the importance of inclusive screening and treatment programs that provide individualized education, psychological support, and metabolic surveillance for children and adolescents with islet autoantibodies.

Dr. Michael J. Haller