Materiały źródłowe

• #1 Type 1 Diabetes | Boston Children’s Hospital

  https://www.childrenshospital.org/conditions/type-1-diabetes

  Type 1 diabetes is an autoimmune disease. The body’s immune system does not recognize the cells in the pancreas that make insulin (beta cells) and attacks and destroys these cells. As a result, the body is unable to produce enough insulin, a hormone that regulates the amount of sugar in the blood. […] To confirm a diagnosis, your child’s doctor may order some or all of the following blood and urine tests: […] Hemoglobin A1C test: a blood test that indicates your child’s average blood sugar level for the past two to three months […] Random blood sugar test: a blood sample taken at a random time […] Fasting blood sugar test: a blood sample taken after an overnight fast […] To help distinguish between type 1 and type 2 diabetes, your child’s doctor may also check for autoantibodies in the blood that are common in type 1 diabetes.

• #1 Type 1 Diabetes Mellitus in Children and Adolescents: Part 1, Overview and Diagnosis | Consultant360

  https://www.consultant360.com/articles/type-1-diabetes-mellitus-children-and-adolescents-part-1-overview-and-diagnosis-1

  Type 1 diabetes mellitus (T1DM) is the most common endocrine problem seen in children and adolescents. T1DM is the result of immune-mediated destruction of pancreatic cells; it involves the formation of autoantibodies against insulin and various enzymes and results in an inability to produce insulin. […] Family physicians and general pediatricians are often responsible for making the initial diagnosis of T1DM in children and then for treating the disease in these patients. In this article, we review the epidemiology and diagnosis of pediatric T1DM. […] Early diagnosis of T1DM is critical to prevent more progressive metabolic decompensation, such as the development of diabetic ketoacidosis (DKA), which is associated with increased morbidity and mortality. The clinical presentation of T1DM in children and adolescents varies depending on the duration of hyperglycemia before diagnosis and treatment. Symptoms and signs can range from mild asymptomatic hyperglycemia alone to hyperglycemia with ketosis and in severe cases, to DKA.

• #1 Type 1 diabetes in children – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/type-1-diabetes-in-children/diagnosis-treatment/drc-20355312

  There are several blood tests for type 1 diabetes in children. These tests are used to diagnose diabetes and to monitor diabetes management: […] This is the primary screening test for type 1 diabetes. A blood sample is taken at a random time. A blood sugar level of 200 milligrams per deciliter (mg/dL), or 11.1 millimoles per liter (mmol/L), or higher, along with symptoms, suggests diabetes. […] This test indicates your child’s average blood sugar level for the past 3 months. An A1C level of 6.5% or higher on two separate tests indicates diabetes. […] A blood sample is taken after your child hasn’t eaten (fasted) for at least 8 hours or overnight. A fasting blood sugar level of 126 mg/dL (7.0 mmol/L) or higher suggests type 1 diabetes. […] If blood sugar testing indicates diabetes, your health care provider may recommend additional tests to distinguish between type 1 diabetes and type 2 diabetes because treatment strategies differ by type. Additional tests include blood tests to check for antibodies that are common in type 1 diabetes.

• #1

  https://www.healthychildren.org/English/health-issues/conditions/chronic/Pages/Diabetes-Mellitus-Type-1-Diabetes.aspx

  Diabetes is diagnosed when a child has the classic symptoms of diabetes described above, along with abnormally high blood sugar levels. Diabetes can also be diagnosed by a test that shows what the average blood sugar has been in the blood over the past 3 months. This test is called hemoglobin A1c (HbA1c). A result that is equal to or greater than 6.5% is consistent with diabetes. […] Less commonly, diabetes is diagnosed with an oral glucose tolerance test (OGTT). With this test, blood sugars are measured before and after a sugary drink is given. […] Having ketones in the urine or coming into the hospital with diabetic ketoacidosis (DKA), where ketone levels have built up to dangerously high levels, strongly suggests type 1 diabetes. However, this can sometimes happen in type 2 diabetes, as well.

• #1 Type 1 Diabetes Mellitus in Children and Adolescents: Part 1, Overview and Diagnosis | Consultant360

  https://www.consultant360.com/articles/type-1-diabetes-mellitus-children-and-adolescents-part-1-overview-and-diagnosis-0

  Early diagnosis of T1DM is critical to prevent more progressive metabolic decompensation, such as the development of diabetic ketoacidosis (DKA), which is associated with increased morbidity and mortality. The clinical presentation of T1DM in children and adolescents varies depending on the duration of hyperglycemia before diagnosis and treatment. Symptoms and signs can range from mild asymptomatic hyperglycemia alone to hyperglycemia with ketosis and in severe cases, to DKA. […] The diagnostic criteria for diabetes, impaired fasting glucose, and impaired glucose tolerance are described in Table 2. In the office setting, a urine dipstick test and a glucose meter reading can be useful screening tests to rule out hyperglycemia, glucosuria, and ketosis; however, a laboratory serum glucose level should always be obtained to confirm the diagnosis. If a patient has clinical symptoms of hyperglycemia or acute metabolic decompensation, only 1 diagnostic laboratory blood glucose test is required; keep in mind that prompt initiation of treatment is called for in this setting. In the absence of typical symptoms, repeat the diagnostic laboratory blood glucose test on another day.

• #1 Type 1 diabetes – Wikipedia

  https://en.wikipedia.org/wiki/Type_1_diabetes

  Type 1 diabetes is diagnosed by testing the level of sugar or glycated hemoglobin (HbA1C) in the blood. […] Once a diagnosis of diabetes is established, type 1 diabetes is distinguished from other types by a blood test for the presence of autoantibodies that target various components of the beta cell. […] The most commonly available tests detect antibodies against glutamic acid decarboxylase, the beta cell cytoplasm, or insulin, each of which are targeted by antibodies in around 80% of type 1 diabetics. […] Some healthcare providers also have access to tests for antibodies targeting the beta cell proteins IA-2 and ZnT8; these antibodies are present in around 58% and 80% of type 1 diabetics respectively. […] Some also test for C-peptide, a byproduct of insulin synthesis. Very low C-peptide levels are suggestive of type 1 diabetes. […] The median age of type one diabetes diagnosis in the US is 24 years of age.

• #1 The pathway to diagnosis of type 1 diabetes in children: a questionnaire study

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4368911/

  To explore the pathway to diagnosis of type 1 diabetes (T1D) in children. […] The most common symptoms were polydipsia (97.7%), polyuria (83.9%), tiredness (75.9%), nocturia (73.6%) and weight loss (64.4%) and all children presented with at least one of those symptoms. […] The time from symptom onset to diagnosis ranged from 2 to 315 days (median 25 days). […] Most of this was the appraisal interval from symptom onset until perceiving the need to seek medical advice. […] Children diagnosed at first consultation had a shorter duration of symptoms (p=0.022) and children whose parents suspected the diagnosis were 1.3 times more likely (relative risk (RR) 1.3, 95% CI 1.02 to 1.67) to be diagnosed at first consultation. […] Children present with the known symptoms of T1D but there is considerable scope to improve the diagnostic pathway.

• #1 Type 1 Diabetes: Causes, Symptoms, Complications & Treatment

  https://my.clevelandclinic.org/health/diseases/21500-type-1-diabetes

  Type 1 diabetes is a chronic (life-long) autoimmune disease that prevents your pancreas from making insulin. Both children and adults can be diagnosed with Type 1 diabetes. […] Symptoms of Type 1 diabetes typically start mild and get progressively worse or more intense, which could happen over several days, weeks or months. See your provider as soon as possible if you or your child experience these symptoms. […] If you or your child has these symptoms, its essential to see your healthcare provider and ask to be tested for Type 1 diabetes as soon as possible. The sooner youre diagnosed, the better. […] Type 1 diabetes is relatively simple to diagnose. If you or your child has symptoms of Type 1 diabetes, your healthcare provider will order the following tests: Blood glucose test, Glycosylated hemoglobin test (A1c), Antibody test.

• #1 Strategies for Earlier Detection of Type 1 Diabetes in Children | AAFP

  https://www.aafp.org/pubs/afp/afp-community-blog/entry/strategies-for-earlier-detection-of-type-1-diabetes-in-children.html

  An estimated 1.8 million people in the United States, or nearly 1 in 250 children and 1 in 200 adults, have type 1 diabetes. One-third of children with type 1 diabetes are diagnosed when they develop diabetic ketoacidosis (DKA), which is not only life-threatening in the short term but is associated with poor long-term glycemic control. […] The American Diabetes Association recommends testing them for pancreatic islet autoantibodies to predict whether they will develop the disease. In a prospective study, children previously identified as being at high risk of type 1 diabetes based on autoantibodies had a low incidence of DKA (3.3%) at the time of diagnosis. […] Not only does the presence of islet autoantibodies have prognostic significance, selected patients may be eligible for teplizumab (Tzield), a monoclonal antibody approved by the U.S. Food and Drug Administration in 2022 to delay the onset of type 2 diabetes in high-risk individuals.

• #1 Type 1 Diabetes | Children’s Hospital of Philadelphia

  https://www.chop.edu/conditions-diseases/type-1-diabetes

  Type 1 diabetes is commonly diagnosed in childhood and adolescence, but it can be diagnosed at any age. If you or your doctor suspects type 1 diabetes, your child’s doctor will order various tests to confirm the diagnosis. These may include: […] If these tests confirm type 1 diabetes, treatment must begin immediately. […] Regular diabetes check-ups are needed at least every three months. These visits help you and the diabetes team take the best care of your child. […] Once a year, your child will have extra screening tests to look for early signs of complications and other conditions that occur more commonly in people with diabetes. […] In Stage 1 type 1 diabetes, a person has at least two antibodies against the pancreas, but has completely normal blood glucose levels. In Stage 2 type 1 diabetes, these antibodies cause enough damage to the pancreas that blood glucose levels are slightly elevated, but the patient still does not have symptoms of diabetes. Stage 2 type 1 diabetes is diagnosed based on the results of oral glucose tolerance testing. In Stage 3 type 1 diabetes, the damage to the pancreas continues to increase, symptoms of diabetes develop, and treatment with insulin is needed. […] Talk to your child’s diabetes care team about having his or her siblings screened for diabetes with a simple blood test.

• #1 Diabetes Mellitus (DM) in Children and Adolescents – Children’s Health Issues – Merck Manual Consumer Version

  https://www.merckmanuals.com/home/children-s-health-issues/hormonal-disorders-in-children/diabetes-mellitus-dm-in-children-and-adolescents

  To help distinguish type 1 diabetes from type 2, doctors do blood tests that detect antibodies to various proteins made by the insulin-producing cells in the pancreas. Antibodies are important to fight off foreign substances such as germs, but sometimes antibodies attack normal cells. In the case of diabetes, cells that make insulin and other chemicals related to insulin are examples of normal cells that can be attacked. Such antibodies are usually present in children with type 1 diabetes and are rarely present in children with type 2 diabetes. Type 1 diabetes is an example of an autoimmune disorder. […] After type 1 diabetes is diagnosed, doctors can determine the stage. Type 1 diabetes progresses in stages: Stage 1: Children have 2 or more diabetes-specific antibodies but have normal blood glucose levels and no symptoms of diabetes. Stage 2: Children have 2 or more diabetes-specific antibodies, abnormal blood glucose levels, and usually no symptoms of diabetes. Stage 3: Children have 2 or more diabetes-specific antibodies, high blood glucose levels, and symptoms of diabetes. Stage 4: Children have type 1 diabetes with severe symptoms (such as kidney malfunction with protein in the urine). […] Children who are diagnosed with type 1 diabetes usually have other blood tests to look for other autoimmune disorders such as celiac disease and thyroid disease. These tests are done at diagnosis and every 1 to 2 years thereafter.

• #1 Stages and diagnosis of T1D | Breakthrough T1D

  https://breakthrought1d.ca/stages-and-diagnosis-of-t1d/

  T1D is fairly predictable with regard to endocrine system function during the honeymoon phase, but every case varies just a bit. […] Screening for early-stage T1D and understanding how the autoimmune process attacks beta cells provide an opportunity to create therapies to delay, or maybe even prevent, the progression of type 1 diabetes. […] Ultimately, the hope is that T1D screening will be a pathway to a cure, catching the disease and treating it before it can start.

• #1 Diabetes Mellitus in Children and Adolescents – Pediatrics – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/pediatrics/endocrine-disorders-in-children/diabetes-mellitus-in-children-and-adolescents

  More than 90% of patients with newly diagnosed type 1 diabetes have 1 of these autoantibodies, whereas the absence of antibodies strongly suggests type 2 diabetes. […] Testing for other autoimmune diseases should be done at or near the time of diagnosis for patients with type 1 diabetes. […] Patients with type 1 diabetes should be tested at or near the time of diagnosis for other autoimmune diseases by measuring celiac disease antibodies and thyroid-stimulating hormone, thyroxine, and thyroid antibodies.

• #1

  https://myhealth.alberta.ca/Health/aftercareinformation/pages/conditions.aspx?hwid=abq4005

  Diabetes can be hard on your child’s body if it’s not well managed. But having certain tests on a regular schedule can help you and your doctor find problems early. Treating problems early can help prevent serious complications. […] Your child’s doctor may vary some of the tests, how often the tests are done, and the goals set for your child. This may depend on your child’s age and size, and whether your child has type 1 or type 2 diabetes. […] For type 1 diabetes, once a year starting at age 12, after your child has had diabetes for 5 years. […] This screening checks for celiac disease. People with type 1 diabetes are at a higher risk of celiac disease than people without diabetes. […] Some diabetes specialists recommend screening within a year of diagnosis of type 1 diabetes.

• #1 Type 1 Diabetes in Children – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK441918/

  The provider will also screen for associated disorders (e.g., thyroid disease, celiac disease, dyslipidemia), ensure screening for complications of chronic hyperglycemia (e.g., retinopathy, neuropathy, nephropathy), and ongoing healthcare maintenance such as influenza vaccine. […] The management of type 1 diabetes requires a diabetes healthcare team may include the medical provider, nurse, diabetes educator, dietician, social worker, and psychologist; However, not all specialties are always available, convenient, or covered by insurance.

• #1 Type 1 Diabetes | Boston Children’s Hospital

  https://www.childrenshospital.org/conditions/type-1-diabetes

  Your child may need to have blood drawn more than once so the test results can be confirmed with a second test on a different day. Distinguishing between type 1 and type 2 diabetes in children can sometimes be difficult, and your child’s doctor may need to do additional testing or monitor your child for some time before the type of diabetes can be confirmed.

• #1 Inaccurate diagnosis of diabetes type in youth: prevalence, characteristics, and implications | Scientific Reports

  https://www.nature.com/articles/s41598-024-58927-6

  Classifying diabetes at diagnosis is crucial for disease management but increasingly difficult due to overlaps in characteristics between the commonly encountered diabetes types. […] We evaluated the prevalence and characteristics of youth with diabetes type that was unknown at diagnosis or was revised over time. […] In the entire cohort, after adjustment for confounders, diabetes type was unknown in 62 youth (3%), associated with older age, negative IA2 autoantibody, lower C-peptide, and no diabetic ketoacidosis (all, p 0.05). […] In sum, among racially/ethnically diverse youth with diabetes, 6.4% had inaccurate diabetes classification at diagnosis. Further research is warranted to improve accurate diagnosis of pediatric diabetes type. […] The prompt and accurate diagnosis of diabetes type is an ongoing issue in the pediatric population.

• #1 Pediatric Type 1 Diabetes Mellitus Differential Diagnoses

  https://emedicine.medscape.com/article/919999-differential

  Conditions to consider in the differential diagnosis of type 1 diabetes include the following: […] Children with MODY may present as having type 1 diabetes. As they may respond better to oral hypoglycemic agents, recognizing MODY as a possibility is important. Always consider the diagnosis of MODY in the following circumstances: […] Diabetes Insipidus […] Monogenic Diabetes […] Type 2 Diabetes Mellitus.

• #1 Distinguishing between Type 1 and Type 2 diabetes in children can be a challenge – Norton Healthcare Provider Louisville, Ky.

  https://nortonhealthcareprovider.com/news/distinguishing-between-type-1-and-type-2-diabetes-in-children-can-be-a-challenge/

  Type 1 diabetes occurs due to cellular mediated autoimmune destruction of beta cells. […] Antibodies used to assess for Type 1 diabetes include islet cell autoantibodies, GAD65, insulin, IA-2 antibodies and, more recently, the zinc transporter 8 autoantibodies. […] C-peptide and insulin levels at the time of diagnosis, before insulin therapy has been initiated, also can have a lot of clinical utility. In Type 1 diabetes, C-peptide and insulin levels are expected to be low and sometimes are undetectable at the time of diagnosis. […] “Initial management of diabetes, no matter whether the underlying diagnosis is Type 1 or Type 2 diabetes, should be targeted toward management of hyperglycemia as well as any metabolic derangements that are present, such as ketonuria or ketosis,” Dr. Gandham said. […] “I think the real key here is that if you have a child and a diagnosis of diabetes has been made, even if a diagnosis of Type 2 diabetes is suspected, obtaining pancreatic autoantibodies is really paramount to making the appropriate management decisions,” Dr. Gandham said.

• #1 Type 1 diabetes in children – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/type-1-diabetes-in-children/diagnosis-treatment/drc-20355312

  Your child’s primary care provider will probably make the initial diagnosis of type 1 diabetes. Hospitalization may be needed to stabilize your child’s blood sugar levels. […] Your child’s long-term diabetes care will likely be handled by a pediatric endocrinologist. Your child’s health care team also generally includes a certified diabetes care and education specialist, a registered dietitian, and a social worker.

• #1 Type 1 Diabetes in Children and Adolescents – Diabetes Canada

  https://www.diabetes.ca/health-care-providers/clinical-practice-guidelines/chapter-34

  Children with new-onset diabetes who present with DKA require a short period of hospitalization to stabilize the associated metabolic derangements and to initiate insulin therapy. […] Improved metabolic control reduces both the onset and progression of diabetes-related complications in adults and adolescents with type 1 diabetes. […] Insulin therapy is the mainstay of medical management of type 1 diabetes. […] Self-monitoring of blood glucose (SMBG) is an essential part of management of type 1 diabetes, and increased frequency has been associated with better clinical outcomes. […] The closed-loop pancreas system, also known as the artificial or bionic pancreas system, is one of the most rapidly evolving areas of clinical care for type 1 diabetes. […] All children with type 1 diabetes should receive counselling from a registered dietitian experienced in pediatric diabetes.

• #1 Where to begin when your child is diagnosed with type 1 diabetes | HealthPartners Blog

  https://www.healthpartners.com/blog/where-to-begin-when-your-child-is-diagnosed-with-type-1-diabetes/

  Managing your childs diabetes can be complex, but its important to treat children with type 1 diabetes just like other children. […] Your child with diabetes will still do what all children do: grow. […] Your childs diabetes care team will include: Pediatric endocrinologist, Pediatrician or family medicine doctor, Certified diabetes care and education specialists (CDCES), School nurse, Mental health specialist. […] Diet can be a challenging aspect of your childs diabetes care plan. […] Children can handle different diabetes care tasks depending on their age, but they should feel involved in their care from a very young age. […] Children with type 1 diabetes may lead lives that look slightly different from those of their peers, but they can be just as rich and fulfilling. […] Effectively managing type 1 diabetes doesnt require perfection, only effort.

• #1 Type 1 Diabetes in Children – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK441918/

  At presentation, children usually have a history of polyuria, polydipsia and weight loss for days to months. […] After diagnosis, and initiation of insulin therapy, follow-up management is typically coordinated by a pediatric endocrinologist on approximately a quarterly basis. […] Hemoglobin A1c is typically measured at clinic visits as a measure of average glucose over the prior two to three months. […] Continuous glucose monitoring (CGM) has become more common in children and adolescents, and measures of „time in range” and glucose variability are likely to be even more valuable than Hemoglobin A1c. […] A diabetes healthcare team may include the medical provider, nurse, diabetes educator, dietician, social worker, and psychologist; However, not all specialties are always available, convenient, or covered by insurance.

• #1 Type 1 Diabetes Mellitus in Children | Phoenix Children’s Hospital

  https://phoenixchildrens.org/specialties-conditions/type-1-diabetes-mellitus-children

  Type 1 diabetes mellitus is a long-term (chronic) condition in which blood glucose levels are abnormally high. It may start at any age. […] Type 1 diabetes is an autoimmune disorder. The body’s immune system damages the cells in the pancreas that make insulin. […] The healthcare provider will ask about your child’s symptoms and health history. They may also ask about your family’s health history. They will give your child a physical exam. Your child may also have blood tests, such as: […] A1C test. This test reflects the average amount of glucose in the blood over the last 2 to 3 months. An elevated A1C result can be used to diagnose diabetes. […] The symptoms of type 1 diabetes can seem like other health conditions. Make sure your child sees their healthcare provider for a diagnosis. […] Children with type 1 diabetes must have daily insulin shots to keep blood glucose levels within normal ranges. […] Without insulin, blood glucose levels continue to rise and death will occur.

• #1 Type 1 Diabetes: Diagnosis and Treatment

  https://www.massgeneral.org/children/diabetes/type-1-diabetes-diagnosis-treatment

  Doctors will test for Type 1 diabetes if your child has symptoms of the condition. A blood test can check your childs blood sugar levels. In some cases, your child might also have high levels of glucose in the urine. This means your child might have diabetes. […] Children with Type 1 diabetes need to take insulin every day to keep their blood sugar levels within a normal range. […] Children with Type 1 diabetes also need to check their blood sugar levels throughout the day. This is done by testing a drop of blood in a blood glucose meter or wearing a continuous glucose monitor (CGM). A CGM is a device worn on the body throughout the day. It checks blood sugar levels automatically without the need to prick your childs finger many times.

• #1

  https://link.springer.com/article/10.1007/s00125-023-05953-0

  Children diagnosed with presymptomatic type 1 diabetes through public health screening have milder diabetes at clinical manifestation […] We aimed to determine whether disease severity was reduced at onset of clinical (stage 3) type 1 diabetes in children previously diagnosed with presymptomatic type 1 diabetes in a population-based screening programme for islet autoantibodies. […] At the diagnosis of stage 3 type 1 diabetes, children with a prior early-stage diagnosis had lower median HbA1c (51 mmol/mol vs 91 mmol/mol [6.8% vs 10.5%], p0.001), lower median fasting glucose (5.3 mmol/l vs 7.2 mmol/l, p0.05) and higher median fasting C-peptide (0.21 nmol/l vs 0.10 nmol/l, p0.001) compared with children without previous early-stage diagnosis. […] Diagnosis of presymptomatic type 1 diabetes in children followed by education and monitoring improved clinical presentation at the onset of stage 3 type 1 diabetes.

• #1 Type 1 Diabetes in Children and Adolescents – Diabetes Canada

  https://www.diabetes.ca/health-care-providers/clinical-practice-guidelines/chapter-34

  Hypoglycemia is a major obstacle for children with type 1 diabetes and can affect their ability to achieve glycemic targets. […] A careful multidisciplinary assessment should be undertaken for every child with chronically poor metabolic control (e.g. A1C 10%) to identify potential causative and associated factors. […] Inadequate levels of physical activity are common in all children, including those with diabetes. Increased physical activity is associated with better metabolic control. […] DKA occurs in approximately 40% of children with new-onset diabetes. […] While most cases of DKA are corrected without event, 0.5% to 1% of pediatric cases are complicated by cerebral edema. […] Children and adolescents with diabetes have significant risks for psychological problems, including diabetes distress, depression, anxiety, eating disorders and externalizing disorders. […] Children and adolescents with diabetes, along with their families, should be screened regularly for psychosocial or psychological disorders.

• #1 Screening children for presymptomatic type 1 diabetes | British Journal of General Practice

  https://bjgp.org/content/73/726/36

  Type 1 diabetes (T1D) is one of the commonest chronic conditions of childhood. The pathophysiology of T1D comprises four stages of which the first two are presymptomatic and hallmarked by autoantibodies, and the last two are accompanied by hyperglycaemia. Screening for autoantibodies enables confident and early identification of children at risk of progression into hyperglycaemia. Benefits of screening include a reduced risk of being diagnosed as a diabetic emergency (diabetic ketoacidosis, DKA), opportunity to prepare the family for a future with T1D, and intervention trials testing new treatments to delay onset of disease. Diagnosis of T1D in children in primary care is challenging and retrospective studies demonstrate missed opportunities for diagnosis. Approximately 23% of children newly diagnosed with T1D in the UK present in DKA, with higher rates observed in children under 5 years. Screening children for autoantibodies would facilitate detection of T1D at the earliest disease stages, that is, stage 1 or stage 2, rather than current practice that detects children at stage 3. Autoantibodies are the only available biomarker to predict future T1D and are found in 3 in 1000 (0.3%) children in the general population. The major benefit from screening children for T1D is a five-fold reduction in DKA rates at stage 3 disease onset. This is achieved by advising the family to monitor for symptoms of T1D and serial OGTT monitoring to track progression towards hyperglycaemia so that insulin can be started sooner. All children found to be at risk of future T1D will be offered monitoring follow-up, for example, through the INNODIA programme. Once the child progresses to stage 3, they would be referred directly into paediatric diabetes service for ongoing management. T1D remains a challenging condition to manage and a quarter of children still present at diagnosis in DKA. Many benefits of paediatric general population screening for T1D have been established including reduction in DKA rates, improvement in HbA1c for 5 years or more, and identification of the high-risk population who could benefit from prevention trials testing new therapies to delay onset of T1D.

• #1 Helping Families Navigate a Type 1 Diabetes Diagnosis in Their Child | University of Utah Health

  https://healthcare.utah.edu/healthfeed/2025/04/helping-families-navigate-type-1-diabetes-diagnosis-their-child

  Each year, about 18,000 children and adolescents are diagnosed with type 1 diabetes in the United States. And that number is increasing at a rate of 2.9% each year. […] Symptoms of type 1 diabetes can often develop quickly but may not raise any red flags in the diseases early stages. […] Its not uncommon for a teacher to notice these symptoms before a parent since a student might be asking to use the bathroom more frequently, says Allison Smego, MD, a pediatric endocrinologist at University of Utah Health. […] Once the diagnosis of stage 3 type 1 diabetes is made, its time for the patient and their family to learn how to manage the condition. […] Current data indicates that teplizumab can delay the onset of stage 3 type 1 diabetes by about two years, though individual responses are variable, Smego explains.

• #1 Helping Families Navigate a Type 1 Diabetes Diagnosis in Their Child | University of Utah Health

  https://healthcare.utah.edu/healthfeed/2025/04/helping-families-navigate-type-1-diabetes-diagnosis-their-child

  Of course, delaying the progression of this disease from stage 1 to stage 3 can only happen when a patient comes in for an early diagnosis, which is easier said than done. […] With the advent of teplizumab, its important for pediatricians and families to consider screening those who are at risk for type 1 diabetes, Smego explains, including those with history of an autoimmune condition or a family history of type 1 diabetes. […] Be sure to always keep your childs diabetes health care team in the loop about any physical, mental, or emotional issues they are dealing with.

• #1 Newly Diagnosed with Type 1 Diabetes – Breakthrough T1D

  https://www.breakthrought1d.org/newly-diagnosed/

  Now diagnosed with type 1 diabetes? We have the information you need to understand and manage the condition. […] A type 1 diabetes diagnosis can be overwhelming. Breakthrough T1D is here to help. […] Many people newly diagnosed with type 1 diabetes can still produce insulin and are eligible for clinical trials that aim to understand how to protect the insulin-producing cells. The window for participation in these studies is usually limited to the first three months, or 100 days, following diagnosis. […] At Breakthrough T1D, we want to make sure everyone is aware of clinical trials for the newly diagnosed so they can make an informed decision about participation.

• #1 Type 1 diabetes in children | Beacon Health System

  https://www.beaconhealthsystem.org/library/diseases-and-conditions/type-1-diabetes-in-children?content_id=CON-20245722

  Type 1 diabetes in children is a condition in which your child’s body no longer produces an important hormone (insulin). […] The diagnosis of type 1 diabetes in children can be overwhelming, especially in the beginning. […] There are several blood tests for type 1 diabetes in children. These tests are used to diagnose diabetes and to monitor diabetes management: […] A blood sample is taken at a random time. A blood sugar level of 200 milligrams per deciliter (mg/dL), or 11.1 millimoles per liter (mmol/L), or higher, along with symptoms, suggests diabetes. […] An A1C level of 6.5% or higher on two separate tests indicates diabetes. […] A fasting blood sugar level of 126 mg/dL (7.0 mmol/L) or higher suggests type 1 diabetes. […] If blood sugar testing indicates diabetes, your health care provider may recommend additional tests to distinguish between type 1 diabetes and type 2 diabetes because treatment strategies differ by type.

• #1 Type 1 Diabetes in Children and Adolescents – Diabetes Canada

  https://www.diabetes.ca/health-care-providers/clinical-practice-guidelines/chapter-34

  Suspicion of diabetes in a child should lead to immediate confirmation of the diagnosis and initiation of treatment to reduce the likelihood of diabetic ketoacidosis. […] Management of pediatric diabetic ketoacidosis differs from diabetic ketoacidosis in adults because of the increased risk for cerebral edema. Pediatric protocols should be used. […] Children should be referred for diabetes education, ongoing care and psychosocial support to a diabetes team with pediatric expertise. […] Diabetes mellitus is the most common endocrine disease and one of the most common chronic conditions in children. […] Children with new-onset type 1 diabetes and their families require intensive diabetes education by an interprofessional pediatric diabetes health-care (DHC) team that should include either a pediatric endocrinologist or pediatrician with diabetes expertise, dietician, diabetes nurse educator, social worker and mental health professional to provide them with the necessary skills and knowledge to manage this disease.

• #1 Type 1 Diabetes: Signs and Symptoms, Diagnosis and Treatment | Nationwide Children’s Hospital

  https://www.nationwidechildrens.org/conditions/diabetes-type-1

  If you have type 1 diabetes, you will need to keep your blood glucose as close to normal as you can. […] Your care team will help you learn how to check your blood glucose, take insulin, count carbohydrates in the foods you eat, and learn what makes your blood glucose change. […] If you suspect your child has diabetes, talk to his or her pediatrician immediately. […] Diabetic Ketoacidosis (DKA) can be very dangerous. If your child has DKA symptoms, contact your health care provider immediately or go to the emergency room.

• #1 Spotting the Signs of Pediatric Type 1 Diabetes | Children’s Healthcare of Atlanta

  https://www.choa.org/parent-resources/diabetes/signs-of-type-1-diabetes

  The key is to address diabetes head on. […] If poorly managed, type 1 diabetes can cause long-term complications into adulthood, including heart disease, stroke, vision impairment, kidney damage, skin problems and nerve damage. […] With lots of support and supervision from you and your childs care team, eventually managing their disease will become just another part of your childs daily routine. […] If your child or teen gets frustrated with having to manage the disease, ask your diabetes management team for the name of a therapist.

• #1 Type 1 Diabetes in Children – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK441918/

  Type 1 diabetes is an autoimmune condition that leads to the destruction of pancreatic beta cells which in turn causes insufficient insulin production, resulting in hyperglycemia. […] This activity reviews the evaluation and management of type 1 diabetes mellitus in children and highlights the role of interprofessional team members in collaborating to provide well-coordinated care and enhance outcomes for affected patients. […] Type 1 diabetes occurs when there is the autoimmune destruction of pancreatic beta cells leading to insufficient insulin production and resulting hyperglycemia. […] Patient and family education is key, as is an acknowledgment of the normal developmental stages and the challenges this brings in the context of daily living with a chronic disease. […] With proper care and support, children and adolescents with type 1 diabetes can expect to lead long and fulfilling lives.

• #1 10 Signs of Type 1 and Type 2 Diabetes in Kids

  https://www.parents.com/health/diabetes/signs-of-diabetes-in-children/

  If your child is showing signs of diabetes, Feller recommends scheduling an appointment with your health care provider. […] Children with diabetes should begin insulin therapy as soon as possible to prevent permanent damage to vision, nerves, and blood vessels, which can lead to other complications.

• #1 Where to begin when your child is diagnosed with type 1 diabetes | HealthPartners Blog

  https://www.healthpartners.com/blog/where-to-begin-when-your-child-is-diagnosed-with-type-1-diabetes/

  When your child is diagnosed with type 1 diabetes, its normal to feel conflicting emotions and to have a lot of questions. […] A type 1 diabetes diagnosis may seem isolating, but youre not alone. […] While your childs doctor can provide answers at your diagnostic appointment, you might not have questions until your child starts treatment at home. […] Sometimes, the immune system attacks the pancreas by mistake. After a few months or years of this, the pancreas cant make insulin anymore. Without insulin, glucose becomes stuck in the bloodstream. This is when the symptoms of type 1 diabetes start to appear. […] Type 1 diabetes can occur at any age, but most children are diagnosed within two age ranges when they are between 4-7 years old and 10-14 years old. […] Unfortunately, no. Type 1 diabetes is a lifelong condition, currently without a cure. Once those insulin-making cells of the pancreas are destroyed, they never come back.

• #2 Type 1 Diabetes: Causes, Symptoms, Complications & Treatment

  https://my.clevelandclinic.org/health/diseases/21500-type-1-diabetes

  Type 1 diabetes is a chronic (life-long) autoimmune disease that prevents your pancreas from making insulin. Both children and adults can be diagnosed with Type 1 diabetes. […] Symptoms of Type 1 diabetes typically start mild and get progressively worse or more intense, which could happen over several days, weeks or months. See your provider as soon as possible if you or your child experience these symptoms. […] If you or your child has these symptoms, its essential to see your healthcare provider and ask to be tested for Type 1 diabetes as soon as possible. The sooner youre diagnosed, the better. […] Type 1 diabetes is relatively simple to diagnose. If you or your child has symptoms of Type 1 diabetes, your healthcare provider will order the following tests: Blood glucose test, Glycosylated hemoglobin test (A1c), Antibody test.

• #2 Type 1 Diabetes Mellitus in Children and Adolescents: Part 1, Overview and Diagnosis | Consultant360

  https://www.consultant360.com/articles/type-1-diabetes-mellitus-children-and-adolescents-part-1-overview-and-diagnosis-0

  Type 1 diabetes mellitus (T1DM) is the most common type of diabetes encountered in children. Early recognition of symptoms of T1DM is critical to avoid life-threatening metabolic decompensation. Such symptoms can include polyuria, polydipsia, fatigue, weight loss, urinary tract infection, vaginal candidiasis, and fruity breath. In the presence of clinical symptoms of hyperglycemia, diagnosis requires just 1 laboratory blood glucose measurement above the established threshold for the child’s age. In the absence of typical symptoms, a second abnormal blood glucose measurement on a different day is needed. […] Type 1 diabetes mellitus (T1DM) is the most common endocrine problem seen in children and adolescents. Family physicians and general pediatricians are often responsible for making the initial diagnosis of T1DM in children and then for treating the disease in these patients.

• #2 Diagnosing Type 1 Diabetes In Children | London Diabetes

  https://londondiabetes.com/type-1/children/diagnosing-type-1-diabetes-in-children/

  Diagnosing type 1 diabetes in children […] If your child is displaying signs and symptoms which could indicate type 1 diabetes, there are a number of tests that are used to make a diagnosis. […] He or she could be required to take several blood tests, including: Random blood sugar test – the primary screening test for the condition, involving a blood sample being taken at a random time. If the blood sugar level is found to be higher than 11.1 mmol/L or 200 mg/dL, this suggests diabetes […] Fasting blood sugar test – this is a test that involves a blood sample taken after your child has fasted overnight. If the blood sugar level is found to be higher than 7.0 mmol/L or 126 mg/dL this suggests type 1 diabetes […] A1C (glycated haemoglobin) test – this is a test to track the average of your child’s blood sugar level over the previous three months. If the A1C level is found to be higher than 6.5 percent in two different tests, this is an indication of diabetes.

• #2 Type 1 Diabetes in Children – Diagnosis & Treatment | PEMC of Florida

  https://www.toplinemd.com/pemc-florida/type-1-diabetes-in-children-diagnosis-treatment/

  Symptoms of type 1 diabetes are often not observable right away and may occur suddenly or advance gradually, whereas in type 2 diabetes insulin production still occurs, yet abnormally. The most common symptoms of diabetes are frequent urination, increased thirst, hunger, weight loss, and fatigue. […] Diagnosing type 1 diabetes in children requires a blood exam. Your child’s doctor has different blood glucose exams that will determine type 1 diabetes. […] The various tests include: Random blood sugar test. Pediatric blood sugar levels are tested at random times. In the presence of symptoms as described above, a random blood sugar level above 200 milligrams per deciliter (mg/dL), or 11.1 millimoles per liter (mmol/L) is consistent with diabetes. […] Glycated hemoglobin (A1C) test which is the average blood glucose for the past three months can be measured and an A1C level of 6.5 percent or higher in two separate exams indicate diabetes.

• #2 Type 1 Diabetes in Children – Diagnosis & Treatment | PEMC of Florida

  https://www.toplinemd.com/pemc-florida/type-1-diabetes-in-children-diagnosis-treatment/

  Fasting blood sugar test. Blood sugar is examined after your child fasts overnight. A Mayo Clinic scientists indicate that a fasting blood sugar level of 126mg/dL (7.0 mmol/L) or higher indicates type 1 diabetes. […] Oral glucose tolerance test can be ordered. A fasting blood sugar is measured and after drinking a sugary drink, a blood sugar test is repeated after 2hrs. A fasting blood sugar of 126 mg/dL and a 2 hrs post prandial blood sugar test above 200 mg/dL is consistent with diabetes.

• #2 Type 1 Diabetes Mellitus in Children and Adolescents: Part 1, Overview and Diagnosis

  https://www.contemporarypediatrics.com/view/type-1-diabetes-mellitus-children-and-adolescents-part-1-overview-and-diagnosis

  Early diagnosis of T1DM is critical to prevent more progressive metabolic decompensation, such as the development of diabetic ketoacidosis (DKA), which is associated with increased morbidity and mortality. The clinical presentation of T1DM in children and adolescents varies depending on the duration of hyperglycemia before diagnosis and treatment. Symptoms and signs can range from mild asymptomatic hyperglycemia alone to hyperglycemia with ketosis—and in severe cases, to DKA. […] The diagnostic criteria for diabetes, impaired fasting glucose, and impaired glucose tolerance are described in Table 2. In the office setting, a urine dipstick test and a glucose meter reading can be useful screening tests to rule out hyperglycemia, glucosuria, and ketosis; however, a laboratory serum glucose level should always be obtained to confirm the diagnosis. If a patient has clinical symptoms of hyperglycemia or acute metabolic decompensation, only 1 diagnostic laboratory blood glucose test is required; keep in mind that prompt initiation of treatment is called for in this setting. In the absence of typical symptoms, repeat the diagnostic laboratory blood glucose test on another day.

• #2 Type 1 diabetes – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/type-1-diabetes/diagnosis-treatment/drc-20353017

  Diagnostic tests include: […] If you’re diagnosed with diabetes, your provider may also run blood tests. These will check for autoantibodies that are common in type 1 diabetes. The tests help your provider decide between type 1 and type 2 diabetes when the diagnosis isn’t certain. […] After diagnosis, you’ll need close medical follow-up until your blood sugar level is stable. A provider who specializes in hormonal disorders (endocrinologist) usually works with other specialists on diabetes care. […] If you think that you or your child might have type 1 diabetes, see your provider immediately. A simple blood test can show if you need more evaluation and treatment.

• #2 Diabetes Mellitus (DM) in Children and Adolescents – Children’s Health Issues – Merck Manual Consumer Version

  https://www.merckmanuals.com/home/children-s-health-issues/hormonal-disorders-in-children/diabetes-mellitus-dm-in-children-and-adolescents

  To help distinguish type 1 diabetes from type 2, doctors do blood tests that detect antibodies to various proteins made by the insulin-producing cells in the pancreas. Antibodies are important to fight off foreign substances such as germs, but sometimes antibodies attack normal cells. In the case of diabetes, cells that make insulin and other chemicals related to insulin are examples of normal cells that can be attacked. Such antibodies are usually present in children with type 1 diabetes and are rarely present in children with type 2 diabetes. Type 1 diabetes is an example of an autoimmune disorder. […] After type 1 diabetes is diagnosed, doctors can determine the stage. Type 1 diabetes progresses in stages: Stage 1: Children have 2 or more diabetes-specific antibodies but have normal blood glucose levels and no symptoms of diabetes. Stage 2: Children have 2 or more diabetes-specific antibodies, abnormal blood glucose levels, and usually no symptoms of diabetes. Stage 3: Children have 2 or more diabetes-specific antibodies, high blood glucose levels, and symptoms of diabetes. Stage 4: Children have type 1 diabetes with severe symptoms (such as kidney malfunction with protein in the urine). […] Children who are diagnosed with type 1 diabetes usually have other blood tests to look for other autoimmune disorders such as celiac disease and thyroid disease. These tests are done at diagnosis and every 1 to 2 years thereafter.

• #2 Distinguishing between Type 1 and Type 2 diabetes in children can be a challenge – Norton Healthcare Provider Louisville, Ky.

  https://nortonhealthcareprovider.com/news/distinguishing-between-type-1-and-type-2-diabetes-in-children-can-be-a-challenge/

  Type 1 diabetes occurs due to cellular mediated autoimmune destruction of beta cells. […] Antibodies used to assess for Type 1 diabetes include islet cell autoantibodies, GAD65, insulin, IA-2 antibodies and, more recently, the zinc transporter 8 autoantibodies. […] C-peptide and insulin levels at the time of diagnosis, before insulin therapy has been initiated, also can have a lot of clinical utility. In Type 1 diabetes, C-peptide and insulin levels are expected to be low and sometimes are undetectable at the time of diagnosis. […] “Initial management of diabetes, no matter whether the underlying diagnosis is Type 1 or Type 2 diabetes, should be targeted toward management of hyperglycemia as well as any metabolic derangements that are present, such as ketonuria or ketosis,” Dr. Gandham said. […] “I think the real key here is that if you have a child and a diagnosis of diabetes has been made, even if a diagnosis of Type 2 diabetes is suspected, obtaining pancreatic autoantibodies is really paramount to making the appropriate management decisions,” Dr. Gandham said.

• #2 Diabetes Mellitus in Children and Adolescents – Pediatrics – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/pediatrics/endocrine-disorders-in-children/diabetes-mellitus-in-children-and-adolescents

  Type 1 diabetes is the most common type in children, accounting for two thirds of new cases in children of all racial and ethnic groups. […] Although type 1 can occur at any age, it is typically diagnosed between age 4 years and 6 years or between age 10 years and 14 years. […] Diagnosis of diabetes and prediabetes is similar to that in adults, typically using fasting or random plasma glucose levels and/or HbA1C levels, and depends on the presence or absence of symptoms. […] Diabetes is diagnosed in patients with characteristic symptoms of diabetes and blood glucose measurements that meet either of the following criteria: Random plasma glucose 200 mg/dL (11.1 mmol/L) or Fasting plasma glucose 126 mg/dL (7.0 mmol/L); fasting is defined as no caloric intake for 8 hours. […] Additional tests should be done to differentiate between types 1 and 2 diabetes (or other types), including C-peptide and insulin (if not yet treated with insulin) levels and tests for autoantibodies against pancreatic islet cell proteins.

• #2 The pathway to diagnosis of type 1 diabetes in children: a questionnaire study | BMJ Open

  https://bmjopen.bmj.com/content/5/3/e006470

  Objective To explore the pathway to diagnosis of type 1 diabetes (T1D) in children. […] The most common symptoms were polydipsia (97.7%), polyuria (83.9%), tiredness (75.9%), nocturia (73.6%) and weight loss (64.4%) and all children presented with at least one of those symptoms. […] The time from symptom onset to diagnosis ranged from 2 to 315 days (median 25 days). […] Most of this was the appraisal interval from symptom onset until perceiving the need to seek medical advice. […] Children present with the known symptoms of T1D but there is considerable scope to improve the diagnostic pathway. […] The majority of parents (61/87, 70%) additionally reported that they had suspected diabetes before their first consultation with a healthcare professional. […] Once parents had sought help, one in five children were then not diagnosed at their first consultation with a healthcare professional, mainly due to being given an alternative diagnosis, most commonly infection, or waiting for further investigations.

• #2 10 Signs of Type 1 and Type 2 Diabetes in Kids

  https://www.parents.com/health/diabetes/signs-of-diabetes-in-children/

  According to the American Diabetes Association, approximately 352,000 people under age 20 have received a diabetes diagnosis and the number keeps on growing. […] Weight changes are common before a diabetes diagnosis especially significant weight loss with type 1 diabetes or slow and excessive weight gain with type 2 diabetes. […] People with diabetes may also have nausea, vomiting, or stomach pains, according to the Centers for Disease Control and Prevention (CDC). These gastrointestinal symptoms tend to be more common with type 1 diabetes. […] Type 1 diabetes is an autoimmune disorder that causes your immune system to attack cells in the pancreas, stopping the natural production of insulin. […] According to the CDC, type 1 diabetes can develop quickly (in a few weeks or months), and it can be severe.

• #2 The pathway to diagnosis of type 1 diabetes in children: a questionnaire study

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4368911/

  The total diagnostic interval ranged from 2 to 315 days with a median (IQR) of 25 days (14-50). […] The diagnostic interval was the shortest of the intervals with a mean SD of 5 days 34.8 and median 0 (IQR; 0-0) days. […] Sixty-nine (78%) children were diagnosed at first consultation. […] Children whose parents suspected the diagnosis (n=61, 70.1%) were more likely (unadjusted relative risk (RR) 1.30, 1.02 to 1.67, p=0.046) to be diagnosed at first consultation (n=52, 85.2%) than those in whom there was no suspicion (n=26, 29.9% with 17 (65.4%) diagnosed at first consultation).

• #2 Screening children for presymptomatic type 1 diabetes | British Journal of General Practice

  https://bjgp.org/content/73/726/36

  Type 1 diabetes (T1D) is one of the commonest chronic conditions of childhood. The pathophysiology of T1D comprises four stages of which the first two are presymptomatic and hallmarked by autoantibodies, and the last two are accompanied by hyperglycaemia. Screening for autoantibodies enables confident and early identification of children at risk of progression into hyperglycaemia. Benefits of screening include a reduced risk of being diagnosed as a diabetic emergency (diabetic ketoacidosis, DKA), opportunity to prepare the family for a future with T1D, and intervention trials testing new treatments to delay onset of disease. Diagnosis of T1D in children in primary care is challenging and retrospective studies demonstrate missed opportunities for diagnosis. Approximately 23% of children newly diagnosed with T1D in the UK present in DKA, with higher rates observed in children under 5 years. Screening children for autoantibodies would facilitate detection of T1D at the earliest disease stages, that is, stage 1 or stage 2, rather than current practice that detects children at stage 3. Autoantibodies are the only available biomarker to predict future T1D and are found in 3 in 1000 (0.3%) children in the general population. The major benefit from screening children for T1D is a five-fold reduction in DKA rates at stage 3 disease onset. This is achieved by advising the family to monitor for symptoms of T1D and serial OGTT monitoring to track progression towards hyperglycaemia so that insulin can be started sooner. All children found to be at risk of future T1D will be offered monitoring follow-up, for example, through the INNODIA programme. Once the child progresses to stage 3, they would be referred directly into paediatric diabetes service for ongoing management. T1D remains a challenging condition to manage and a quarter of children still present at diagnosis in DKA. Many benefits of paediatric general population screening for T1D have been established including reduction in DKA rates, improvement in HbA1c for 5 years or more, and identification of the high-risk population who could benefit from prevention trials testing new therapies to delay onset of T1D.

• #2 Diagnosis and treatment of type 1 diabetes at the dawn of the personalized medicine era | Journal of Translational Medicine | Full Text

  https://translational-medicine.biomedcentral.com/articles/10.1186/s12967-021-02778-6

  This knowledge has led to development of a staging classification system for T1D. […] Even once T1D is clinically evident, we are now beginning to appreciate that not all cases are the same, and that particular sub-types of the disease would benefit from distinct treatment strategies. […] By dissecting population- and individual-level risk factors for developing T1D, we now know that the disorder exists across developmental spectrum that can be categorized into distinct stages, and the likelihood of an individual developing clinically symptomatic status can be foreseen with considerable accuracy. […] The sequence of events from emerging autoimmunity to dysglycemia and then to overt diabetes occurs along this predictable course, but the length of each stage may vary broadly between different individuals.

• #2 Stages of Type 1 | Emory School of Medicine

  https://med.emory.edu/departments/pediatrics/divisions/endocrinology/research/what-is-diabetes/type-1-stages.html

  Stage 3 is when clinical diagnosis typically takes place. By this time, there is significant beta cell loss and symptoms of type 1 diabetes are usually present. […] Clinical T1D diagnosis + significant beta cell loss + Symptoms of T1D

• #2

  https://link.springer.com/article/10.1007/s00125-023-05953-0

  This study found that children who had been previously diagnosed with presymptomatic type 1 diabetes in a public health screening programme had a milder clinical presentation at diagnosis of stage 3 type 1 diabetes than children without prior screening for islet autoantibodies. […] The findings support the hypothesis that screening for presymptomatic early stages of type 1 diabetes reduces disease severity at clinical onset. […] By identifying children with presymptomatic type 1 diabetes and offering them participation in education and metabolic follow-up, the clinical presentation at manifestation of stage 3 type 1 diabetes is improved.

• #2 Type 1 Diabetes in Children – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK441918/

  The provider will also screen for associated disorders (e.g., thyroid disease, celiac disease, dyslipidemia), ensure screening for complications of chronic hyperglycemia (e.g., retinopathy, neuropathy, nephropathy), and ongoing healthcare maintenance such as influenza vaccine. […] The management of type 1 diabetes requires a diabetes healthcare team may include the medical provider, nurse, diabetes educator, dietician, social worker, and psychologist; However, not all specialties are always available, convenient, or covered by insurance.

• #2 Inaccurate diagnosis of diabetes type in youth: prevalence, characteristics, and implications | Scientific Reports

  https://www.nature.com/articles/s41598-024-58927-6

  Classifying diabetes at diagnosis is crucial for disease management but increasingly difficult due to overlaps in characteristics between the commonly encountered diabetes types. […] We evaluated the prevalence and characteristics of youth with diabetes type that was unknown at diagnosis or was revised over time. […] In the entire cohort, after adjustment for confounders, diabetes type was unknown in 62 youth (3%), associated with older age, negative IA2 autoantibody, lower C-peptide, and no diabetic ketoacidosis (all, p 0.05). […] In sum, among racially/ethnically diverse youth with diabetes, 6.4% had inaccurate diabetes classification at diagnosis. Further research is warranted to improve accurate diagnosis of pediatric diabetes type. […] The prompt and accurate diagnosis of diabetes type is an ongoing issue in the pediatric population.

• #2 Inaccurate diagnosis of diabetes type in youth: prevalence, characteristics, and implications | Scientific Reports

  https://www.nature.com/articles/s41598-024-58927-6

  Therefore, accurate and timely diagnosis of diabetes type at the time of diabetes onset is crucial. […] A substantial percentage of those with unknown diabetes type at the onset of diabetes were diagnosed with T2D at 34 years post-diagnosis. […] This aligns with our observation that a lack of T1D-suggestive phenotypic features in children plays an important role in delayed determination of diabetes type and underscores the urgent need for better diagnostic tools and biomarkers to confirm the timely diagnosis of T2D in children. […] In conclusion, one in 15 children is affected by inaccurate diagnosis of diabetes type in a racially and ethnically diverse pediatric diabetes population.

• #2 When to get your child tested for Type 1 diabetes | Nebraska Medicine Omaha, NE

  https://www.nebraskamed.com/health/conditions-and-services/diabetes/when-to-get-your-child-tested-for-type-1-diabetes

  Often, Type 1 diabetes patients are initially hospitalized. They are treated by a multidisciplinary team, including diabetes educators who share individualized guidance for diabetes care. […] Because Type 1 diabetes is a chronic condition, these individuals will need to manage their diabetes for the rest of their lives.

• #2 Where to begin when your child is diagnosed with type 1 diabetes | HealthPartners Blog

  https://www.healthpartners.com/blog/where-to-begin-when-your-child-is-diagnosed-with-type-1-diabetes/

  Managing your childs diabetes can be complex, but its important to treat children with type 1 diabetes just like other children. […] Your child with diabetes will still do what all children do: grow. […] Your childs diabetes care team will include: Pediatric endocrinologist, Pediatrician or family medicine doctor, Certified diabetes care and education specialists (CDCES), School nurse, Mental health specialist. […] Diet can be a challenging aspect of your childs diabetes care plan. […] Children can handle different diabetes care tasks depending on their age, but they should feel involved in their care from a very young age. […] Children with type 1 diabetes may lead lives that look slightly different from those of their peers, but they can be just as rich and fulfilling. […] Effectively managing type 1 diabetes doesnt require perfection, only effort.

• #2 Diabetes in young children | Pregnancy Birth and Baby

  https://www.pregnancybirthbaby.org.au/diabetes-in-young-children

  Insulin may be given by injection or with an insulin pen, or through an insulin pump. […] You will need to monitor your child’s blood glucose levels regularly by testing a drop of their blood with a special device (called a glucometer). […] Blood sugar levels that are too low (hypoglycaemia) or too high (hyperglycaemia) can be dangerous. Your child’s diabetes management team will teach you how to recognise and manage high and low blood sugar levels.

• #2 Strategies for Earlier Detection of Type 1 Diabetes in Children | AAFP

  https://www.aafp.org/pubs/afp/afp-community-blog/entry/strategies-for-earlier-detection-of-type-1-diabetes-in-children.html

  A subsequent trial showed that teplizumab preserves -cell function in patients with newly diagnosed type 1 diabetes but does not improve clinical outcomes. […] However, it is not known whether screening the general population for type 1 diabetes with genetic or autoantibody tests would lead to more benefits than harms. […] A June 2024 study in The Lancet used electronic health records from more than 2 million children in Wales to develop and validate a predictive algorithm for type 1 diabetes based on 26 symptoms, history elements, and timing of primary care visits. […] Although the researchers asserted that implementing the algorithm would substantially reduce the proportion of patients with new-onset type 1 diabetes presenting in DKA, they acknowledged that further studies are needed to test the feasibility of this strategy and its relationship to alert fatigue and clinician burnout in practice.

• #2 Where to begin when your child is diagnosed with type 1 diabetes | HealthPartners Blog

  https://www.healthpartners.com/blog/where-to-begin-when-your-child-is-diagnosed-with-type-1-diabetes/

  When your child is diagnosed with type 1 diabetes, its normal to feel conflicting emotions and to have a lot of questions. […] A type 1 diabetes diagnosis may seem isolating, but youre not alone. […] While your childs doctor can provide answers at your diagnostic appointment, you might not have questions until your child starts treatment at home. […] Sometimes, the immune system attacks the pancreas by mistake. After a few months or years of this, the pancreas cant make insulin anymore. Without insulin, glucose becomes stuck in the bloodstream. This is when the symptoms of type 1 diabetes start to appear. […] Type 1 diabetes can occur at any age, but most children are diagnosed within two age ranges when they are between 4-7 years old and 10-14 years old. […] Unfortunately, no. Type 1 diabetes is a lifelong condition, currently without a cure. Once those insulin-making cells of the pancreas are destroyed, they never come back.

• #2 Diabetes in children and teenagers: Symptoms and diagnosis

  https://www.medicalnewstoday.com/articles/284974

  Type 1 diabetes in children, previously called juvenile diabetes, occurs when the pancreas is unable to produce insulin. […] People can develop type 1 diabetes at any age, from early childhood to adulthood, but the average age at diagnosis is 13 years. An estimated 85% of all type 1 diagnoses take place in people aged under 20 years. […] The outcomes for children with type 1 or type 2 diabetes improve greatly with early detection. […] Any child with signs or symptoms of diabetes should see a doctor for screening. This may consist of a urine test to look for sugar in the urine or a finger-prick blood test to check the child’s glucose levels. […] Diabetes rates in childhood and adolescence are rising. Type 1 diabetes is much more common in young people than type 2 diabetes, but the rates of both are increasing. […] When they control the condition well, people with diabetes can live full and healthy lives.

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