Type 1 Diabetes Antibody Screening: Keys for Early Intervention and Risk Determination

Opinion
Video

Dr Jennifer D. Goldman and Marianne Briggs, DNP, FNP-C explore the critical role of antibodies in determining T1D progression and emphasize the importance of regular screening. In this segment learn about the four main antibodies pivotal in T1D screening and stage progression.


The following transcript has been lightly edited for clarity and style.

Dr Jennifer Goldman: Why do you think screening for progression through type 1 diabetes stages is important? Select all that apply. Why do you think it's important? Well, clearly we're all preaching. We have an opportunity now. Excellent. How frequently do you screen primary populations for type 1 diabetes stage progression during routine appointments? So, occasionally, often, so pretty mixed, and some never. And hopefully this will create some thinking. And one last thing, how do you typically screen primary populations for type 1 diabetes risk factors during routine appointments?

Those who said you do do it on occasion, how are you doing them? OK, so 45% are using autoantibodies. So we alluded to this already, and the increased risk with autoimmune diseases in high risk population and statistics, so let's kind of move through. I want to get to the antibodies and to the teplizumab data. So how familiar are you everyone with the concept of antibody levels serving as biomarkers for progression and treatment response? So let's talk a little bit about those antibodies.

Are these the tests that you're checking, and do you have something set up like a protocol or something in your medical record that let's say you have someone at risk that you just have some special magic that you order, or do you type all these in individually?

Marianne Briggs: So for, I think it depends on your computer system also. You can set it up to be your favorites or it auto-populates. I think because through my progression of being here for four years, I've learned, it's just, this is what I need. I know I need it. One of the zinc transporter eight, it has to be- in our lab, it has to be written on a piece of paper. And my nurses know when I ask for the piece of paper, they know exactly what it is to bring to me because that's- it's just what we have to do. It's so important because that's what's going to help us be able to treat the patient.

Dr. Jennifer Goldman: So these are the four critical antibodies, and that's recommended in the ADA standards of care. And so you get it from your labs, commercial labs, but there are other places you can get that done. TrialNet and online and so forth. But let me go back for one second. So, two auto antibodies detected, which you've explained it in depth and making sure that those patients have follow-up. And that patient that you talked about with those two antibodies that does not have dysglycemia, so the follow up plan that you're doing in your practice is six months.


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