{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,19]],"date-time":"2026-09-19T12:15:47Z","timestamp":1789820147793,"version":"4.0.1"},"reference-count":42,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2024,2,20]],"date-time":"2024-02-20T00:00:00Z","timestamp":1708387200000},"content-version":"vor","delay-in-days":19,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Diabetes Metabolism Res"],"published-print":{"date-parts":[[2024,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background\/Aim<\/jats:title><jats:p>Type 1 diabetes is an autoimmune disease that involves the development of autoantibodies against pancreatic islet beta\u2010cell antigens, preceding clinical diagnosis by a period of preclinical disease activity. As screening activity to identify autoantibody\u2010positive individuals increases, a rise in presymptomatic type 1 diabetes individuals seeking medical attention is expected. Current guidance on how to monitor these individuals in a safe but minimally invasive way is limited. This article aims to provide clinical guidance for monitoring individuals with presymptomatic type 1 diabetes to reduce the risk of diabetic ketoacidosis (DKA) at diagnosis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Expert consensus was obtained from members of the Fr1da, GPPAD, and INNODIA consortia, three European diabetes research groups. The guidance covers both specialist and primary care follow\u2010up strategies.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The guidance outlines recommended monitoring approaches based on age, disease stage and clinical setting. Individuals with presymptomatic type 1 diabetes are best followed up in specialist care. For stage 1, biannual assessments of random plasma glucose and HbA1c are suggested for children, while annual assessments are recommended for adolescents and adults. For stage 2, 3\u2010monthly clinic visits with additional home monitoring are advised. The value of repeat OGTT in stage 1 and the use of continuous glucose monitoring in stage 2 are discussed. Primary care is encouraged to monitor individuals who decline specialist care, following the guidance presented.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>As type 1 diabetes screening programs become more prevalent, effective monitoring strategies are essential to mitigate the risk of complications such as DKA. This guidance serves as a valuable resource for clinicians, providing practical recommendations tailored to an individual's age and disease stage, both within specialist and primary care settings.<\/jats:p><\/jats:sec>","DOI":"10.1002\/dmrr.3777","type":"journal-article","created":{"date-parts":[[2024,2,20]],"date-time":"2024-02-20T10:40:55Z","timestamp":1708425655000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":41,"title":["Clinical care advice for monitoring of islet autoantibody positive individuals with presymptomatic type 1 diabetes"],"prefix":"10.1002","volume":"40","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0795-1832","authenticated-orcid":false,"given":"A. Emile J.","family":"Hendriks","sequence":"first","affiliation":[{"name":"Department of Paediatrics University of Cambridge  Cambridge UK"},{"name":"Department of Paediatric Diabetes and Endocrinology Cambridge University Hospitals NHS Foundation Trust  Cambridge UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M. Loredana","family":"Marcovecchio","sequence":"additional","affiliation":[{"name":"Department of Paediatrics University of Cambridge  Cambridge UK"},{"name":"Department of Paediatric Diabetes and Endocrinology Cambridge University Hospitals NHS Foundation Trust  Cambridge UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rachel E. J.","family":"Besser","sequence":"additional","affiliation":[{"name":"Diabetes and Inflammation Laboratory Wellcome Centre for Human Genetics Nuffield Department of Medicine Oxford NIHR Biomedical Research Centre University of Oxford  Oxford UK"},{"name":"Department of Paediatrics University of Oxford  Oxford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ezio","family":"Bonifacio","sequence":"additional","affiliation":[{"name":"Technische Universit\u00e4t Dresden Center for Regenerative Therapies Dresden  Dresden Germany"},{"name":"German Center for Diabetes Research (DZD e.V.)  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