![]() ![]() These findings may inform considerations of population-based screening of children for islet autoantibodies. Median (IQR) psychological stress scores were significantly increased at the time of metabolic staging in mothers of children with presymptomatic type 1 diabetes (3 ) compared with mothers of children without islet autoantibodies (2 ) ( P = .002), but declined after 12 months of follow-up (2 ) ( P < .001).Ĭonclusions and Relevance Among children aged 2 to 5 years in Bavaria, Germany, a program of primary care–based screening showed an islet autoantibody prevalence of 0.31%. The 3-year cumulative risk for stage 3 type 1 diabetes in the 280 children with presymptomatic type 1 diabetes was 24.9% ( 54 cases annualized rate, 9.0%). After a median (IQR) follow-up of 2.4 (1.0-3.2) years, another 36 children developed stage 3 type 1 diabetes. Secondary outcomes were the frequency of diabetic ketoacidosis and parental psychological stress, assessed by the Patient Health Questionnaire-9 (range, 0-27 higher scores indicate worse depression ≤4 indicates no to minimal depression >20 indicates severe depression). Main Outcomes and Measures The primary outcome was presymptomatic type 1 diabetes, defined by 2 or more islet autoantibodies, with categorization into stages 1 (normoglycemia), 2 (dysglycemia), or 3 (clinical) type 1 diabetes. ![]() ![]() Families of children with multiple islet autoantibodies (presymptomatic type 1 diabetes) were invited to participate in a program of diabetes education, metabolic staging, assessment of psychological stress associated with diagnosis, and prospective follow-up for progression to clinical diabetes until July 31, 2019.Įxposures Measurement of islet autoantibodies. Objective To determine the prevalence of presymptomatic type 1 diabetes in children participating in a public health screening program for islet autoantibodies and the risk for progression to clinical diabetes.ĭesign, Setting, and Participants Screening for islet autoantibodies was offered to children aged 1.75 to 5.99 years in Bavaria, Germany, between 20 by primary care pediatricians during well-baby visits. Importance Public health screening for type 1 diabetes in its presymptomatic stages may reduce disease severity and burden on a population level. Shared Decision Making and Communication.Scientific Discovery and the Future of Medicine.Health Care Economics, Insurance, Payment.Clinical Implications of Basic Neuroscience.Challenges in Clinical Electrocardiography.Patient Health Questionnaire-9 Depression Scores of Mothers and Fathers from Children with Presymptomatic Type 1 Diabetes, Children in the Fr1da Control Cohort, and Children with Symptomatic New-Onset Type 1 Diabetes in the DiMelli Cohort Combinations of Autoantibodies in Fr1da Children with Presymptomatic Type 1 DiabetesĮTable 2. Risk of developing Stage 2 or Stage 3 Type 1 Diabetes with Censoring of Children who Participated in the Fr1da Intervention TrialĮTable 1. Risk of Developing Stage 2 or Stage 3 Type 1 DiabetesĮFigure 8. Risk of Stage 3 Type 1 Diabetes with Censoring of Children who Participated in the Fr1da Intervention TrialĮFigure 7. Risk of Stage 3 Type 1 Diabetes According to GAD Autoantibody StatusĮFigure 6. Risk of Developing Stage 3 Type 1 diabetesĮFigure 5. Unadjusted Relative Risk Ratios for Presymptomatic Type 1 DiabetesĮFigure 4. ![]() Violin and Box Plots of Type 1 Diabetes Genetic Risk Scores in the Fr1da, DiMelli, and Freder1k StudiesĮFigure 3. Regions of Bavaria Participating in the Fr1da StudyĮFigure 2. ![]()
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