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Time to reframe the disease staging system for type 1 diabetes.
Lancet Diabetes Endocrinol
December 2024
Department of Paediatrics, Diabetes Center, University of California San Francisco, San Francisco, California, USA.
Article Synopsis
- A disease staging system introduced in 2015 helps identify and track progression to clinical type 1 diabetes based on islet autoantibodies and dysglycaemia, but it has significant limitations such as combining diverse individuals and lacking high specificity.
- Although the current model suggests a linear progression through stages, real-life progression is often more complex, and factors like age are not considered.
- With the recent FDA approval of teplizumab to delay type 1 diabetes at stage 2, there's a need to refine diabetes staging definitions and develop a risk calculator that considers a wider range of demographic, genetic, and metabolic data, especially in underrepresented groups.
Trajectory of beta cell function and insulin clearance in stage 2 type 1 diabetes: natural history and response to teplizumab.
Diabetologia
November 2024
Department of Pediatrics, University of Minnesota, Minneapolis, MN, USA.
Aims/hypothesis: We aimed to analyse TrialNet Anti-CD3 Prevention (TN10) data using oral minimal model (OMM)-derived indices to characterise the natural history of stage 2 type 1 diabetes in placebo-treated individuals, to describe early metabolic responses to teplizumab and to explore the predictive capacity of OMM measures for disease-free survival rate.
Methods: OMM-estimated insulin secretion, sensitivity and clearance and the disposition index were evaluated at baseline and at 3, 6 and 12 months post randomisation in placebo- and teplizumab-treated groups, and, within each group, in slow- and rapid-progressors (time to stage 3 disease >2 or 2 years). OMM metrics were also compared with the standard AUC C-peptide.
CVOT Summit Report 2023: new cardiovascular, kidney, and metabolic outcomes.
Cardiovasc Diabetol
March 2024
Forschergruppe Diabetes e. V, Helmholtz Center Munich, Ingolstaedter Landstraße 1, 85764, Neuherberg (Munich), Germany.
Article Synopsis
- The 9th Cardiovascular Outcome Trial (CVOT) Summit took place online from November 30 to December 1, 2023, focusing on recent outcomes trials involving medications like dapagliflozin, semaglutide, and bempedoic acid aimed at reducing major cardiovascular events and improving metabolic health.
- A diverse group of healthcare professionals discussed updates in the management of cardiovascular disease in patients with diabetes, heart failure, and chronic kidney disease, alongside the latest treatments for type 1 diabetes and obesity.
- The Summit emphasized the need for diversity in clinical trial participants and the importance of patient-reported outcomes, advocating for personalized treatment strategies and the integration of continuous glucose monitoring technology in managing diabetes
Use of teplizumab in children and adolescents at risk of type 1 diabetes: perspectives of parents and caregivers from an Italian Pediatric Diabetes Center.
Acta Diabetol
May 2024
Department of Human Pathology in Adult and Developmental Age "Gaetano Barresi", University of Messina, Via Consolare Valeria 1, 98124, Messina, ME, Italy.
Aims: In view of the imminent introduction of a novel category of disease-modifying treatments for type 1 diabetes (T1D) in European countries, it becomes imperative to understand the existing awareness and viewpoints of parents and caregivers of children and adolescents predisposed to T1D. This study aims to evaluate the perspectives of a cohort of parents and caregivers regarding using teplizumab to delay the onset of T1D in predisposed children and adolescents.
Methods: This single-center study used a survey-based approach.
Teplizumab: promises and challenges of a recently approved monoclonal antibody for the prevention of type 1 diabetes or preservation of residual beta cell function.
Expert Rev Clin Immunol
February 2024
Division of Endocrinology and Metabolism and Diabetes Center, First Department of Internal Medicine, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece.
Introduction: Type 1 diabetes (T1D) is a chronic autoimmune endocrinopathy with increasing incidence that results in the depletion of pancreatic beta cells and exogenous insulin dependence. Despite technological advances in insulin delivery, disease control remains suboptimal, while previous immunotherapy options have failed to prevent T1D. Recently, teplizumab, an immunomodulating monoclonal antibody, was approved to delay or prevent T1D.
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