Review of international practice of screening and monitoring of type 1 diabetes mellitus at preclinical stages

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Abstract
Type 1 diabetes is an autoimmune disease that causes damage and destruction of the pancreatic islet beta cells, leading to insufficient insulin production, followed by metabolic disturbances and clinically overt hyperglycemia, which requires lifelong insulin therapy. Currently, it is possible to detect the disease at preclinical stages, when pancreatic islet beta-cell function is sufficient to prevent hyperglycemia and the need for insulin therapy, by determining antibodies to islet cells (ICA, IA-2, GAD, IAA, Zn8T). Due to the high relevance and growing demands from the medical community regarding the problem of early diagnosis of T1D and the need to standardize approaches, several international guidelines on screening and monitoring individuals with positive autoantibodies (AAb) at preclinical stages of T1D were published during 2024. Monitoring these patients will reduce the risk of DKA, give them and their families more time to acquire knowledge and skills for diabetes management, and may also reduce anxiety and stress associated with the onset of the clinical stage of T1D. This review analyzes and compares international approaches to screening and monitoring the preclinical stages of T1D.

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