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American Diabetes Association and European Association for the Study of Diabetes Consensus Statement Highlights Importance of Accurate Diagnosis and Management of Type 1 Diabetes in Adults

Cardi-OH

 

A recently released consensus statement from the American Diabetes Association and the European Association for the Study of Diabetes provides a comprehensive update on the diagnosis and management of Type 1 diabetes mellitus (T1DM) in adults. The statement acknowledges the rapid development of new treatments and technologies and focuses on many topics relevant for T1DM diagnosis including individualized glycemic targets, hypoglycemia management, glucose monitoring, psychosocial support, and the role of diabetes self-management education and support (DSMES). A detailed framework for follow-up care is also provided (Table 2).

Accurate differentiation of diabetes type is key for initiating insulin regimen, patient education, and support. Although new-onset T1DM occurs in all age groups, adult patients with T1DM are commonly misclassified as T2DM, which could result in delayed initiation of appropriate therapy and increased risk of complications. The report provides a flow chart (Figure 1) to aid the diagnosis of suspected T1DM. Islet autoantibodies should be tested, beginning with anti-GAD (glutamic acid decarboxylase), followed by evaluation for clinical features of monogenic diabetes and T2DM, and evaluation of endogenous insulin production with C-peptide.


  1. Holt RIG, DeVries JH, Hess-Fischl A, et al. The management of type 1 diabetes in adults. A consensus report by the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD). Diabetes Care. 44(11):2589-2625. https://doi.org/10.2337/dci21-0043.
     
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