T1D Information for PROVIDERS

2. Most children with T1D (90%)  DO NOT have a family member with T1D.

Although children who have a family member with T1D have a 15-20x increased risk of developing T1D, the large majority of children diagnosed with T1D (90%) do not have a family history of T1D. Because the clinical symptoms of T1D overlap with common pediatric illnesses, T1D is often unrecognized in families who are not familiar with T1D signs and symptoms.

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3. Screening for T1D and monitoring patients who screen positive over time can prevent diabetic ketoacidosis (DKA) and may improve long term glycemic control.

The rate of diabetic ketoacidosis (DKA) at the time of T1D onset is increasing over time throughout the U.S. Although rates vary across the United States, in Colorado 58% of children diagnosed with T1D present in DKA. DKA is life threatening and associated with complications such as cerebral edema, memory and cognitive defects and worsened long-term glycemic control, thereby increasing the risk for vascular complications. An estimated 120 children in the U.S. die every year as the result of a delayed diagnosis of T1D. Children detected by screening for T1D associated antibodies rarely progress to DKA. Prior studies at the Barbara Davis Center, including the TEDDY and DAISY studies have shown that 90% of children who know they have the T1D associated antibodies and are connected with a healthcare team for routine metabolic monitoring avoid DKA at onset of diabetes. 

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4. T1D Prevention trials may be available if your patient screens positive. 

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5. Therapies approved for early T1D treatment

On November 17, 2022, the FDA approved TZIELD (teplizumab). TZIELD is the first FDA-approved treatment for early diabetes and has the potential to delay the onset of clinical type 1 diabetes (T1D). It is approved for adults and pediatric patients aged 8 years and older with Stage 2 T1D. Stage 2 T1D is when a person has 2 or more T1D-associated autoantibodies (GAD, IAA, IA-2, ICA512, and/or ZnT8A) and dysglycemia. Dysglycemia in stage 2 T1D is defined by the American Diabetes Association as a fasting blood glucose of 100-125 mg/dl, a 2-hour glucose during an oral glucose tolerance test of 140-199 mg/dl or an HbA1c between 5.7-6.4%. 

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Research done in TrialNet showed that people who received TZIELD had an average of 2 more years before the onset of clinical T1D (Stage 3 T1D) compared to those who did not receive TZIELD. Additionally, more people who were given TZIELD had not been diagnosed with Stage 3 T1D by the end of the study compared with people who did not receive TZIELD. TZIELD is given as an intravenous (IV) infusion once a day, every day, for 14 days. TZIELD is an anti-CD3 monoclonal antibody that may work by changing the phenotype of activated T-cells. Evaluation for Tzield treatment can take place at the Barbara Davis Center Early T1D Clinic in Aurora, CO, or in several other locations throughout the United States that may be closer to you.