The Importance of Screening for T1D Risk: What We Know and Where We’re Going

The Importance of Screening for T1D Risk: What We Know and Where We’re Going

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Released: 6/15/2021
Expires: 9/30/2022
Max Credits: 1.0
Continue to Course Read Abstract

Jay H. Shubrook, DO, FACOFP, FAAFP, BC-ADM
Professor, Primary Care Department
Director, Clinical Research and Diabetes Services
College of Osteopathic Medicine
Touro University California
Vallejo, CA

Jennifer McVean, MD
Associate Professor
Department of Pediatrics
Division of Pediatric Endocrinology
University of Minnesota Medical School
Minneapolis, MN

Activity Planners
Marian Rewers, MD, PhD
Professor of Pediatrics and Medicine
Richard S. Abrams Endowed Chair
Executive Director, Barbara Davis Center for Diabetes
University of Colorado School of Medicine
Aurora, CO

Jennifer L. Gwilym, DO, FAAFP, FACOFP, HPF, CS
Assistant Professor, Family Medicine OU-HCOM
Assistant Dean of Clinical Education
Athens, OH

Garrett Kirkpatrick, DO
UPMC BMA Keystone Family Medicine
Altoona, PA

Jaime Symowicz, PhD
Manager, Educational Strategy and Content
Baltimore, MD

Jane Frutchey, MS
Associate Editorial Manager
Baltimore, MD

Samantha Gordon, MS
Accreditation Manager 
Baltimore, MD

Amy Sison
Director of CME
Baltimore, MD

Jessica Martin, PhD
Saint Paul, MN

Learning Objectives
Upon completion, participants should be able to:

  • Identify the different stages of T1D and the importance of preventing DKA at T1D diagnosis
  • Inform patients and families about the benefits and limitations of available T1D autoantibody screening tests
  • Summarize monitoring guidance and available support resources for individuals who have tested positive for T1D autoantibodies
  • Describe therapies that are currently being investigated to slow T1D progression in individuals who have a high risk of developing T1D and in those with new-onset T1D

Target Audience
This activity is intended for primary care providers, endocrinologists, pediatricians, pediatric endocrinologists, nurse practitioners, physician assistants, certified diabetes care and education specialists, nurses, and pharmacists.
Statement of Need
About one-half of children are diagnosed with type 1 diabetes (T1D) while experiencing diabetic ketoacidosis (DKA), a potentially life-threatening complication of uncontrolled T1D. The presence of T1D autoantibodies is a risk factor for progression to clinical T1D, and screening for these autoantibodies has been associated with a lower incidence of DKA at T1D diagnosis in children with a genetic risk of T1D. The ADA clinical practice guidelines currently recommend screening for autoantibodies with a research trial or for first-degree relatives of a person with T1D. However, approximately 90% of individuals diagnosed with T1D do not have an affected first-degree relative. To address this, T1D autoantibody screening tests and programs are now available for individuals with or without a family history of T1D. Because in-home screening tests can now be accessed by the general public, primary care providers, including family physicians, need to be familiar with their benefits and limitations, best practices for supporting and monitoring patients after receiving their results, and investigational therapies that may help slow T1D progression in individuals with a high risk of developing T1D or new-onset T1D.

Collaboration Statement
This activity was developed by Med-IQ in collaboration with JDRF.

Med-IQ      JDRF

Accreditation/Designation Statements
Med-IQ is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.  

Med-IQ designates this enduring material for a maximum of 1.0 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
Medium/Method of Participation
This is a 1.0-credit CE activity. To receive credit, read the introductory CE material, complete all of the modules, and complete the evaluation, attestation, and post-test, answering at least 70% of the post-test questions correctly. 

Initial Release Date: June 15, 2021
Expiration Date: September 30,2022
Estimated Time to Complete This Activity: 1 hour

Disclosure Policy
Med-IQ requires any person in a position to control the content of an educational activity to disclose all relevant financial relationships with any commercial interest. The ACCME defines “relevant financial relationships” as those in any amount occurring within the past 24 months that could create a conflict of interest (COI). Individuals who refuse to disclose will not be permitted to contribute to this CME activity in any way. Med-IQ has policies in place that will identify and resolve COIs prior to this educational activity. Med-IQ also requires faculty to disclose discussions of investigational products or unlabeled/unapproved uses of drugs or devices regulated by the US Food and Drug Administration.

Drug/Product Usage by Faculty
Off-label/unapproved drug uses or products are mentioned within this activity. 

Disclosure Statement
The content of this activity has been peer reviewed and has been approved for compliance. The faculty and contributors have indicated the following financial relationships, which have been resolved through an established COI resolution process, and have stated that these reported relationships will not have any impact on their ability to give an unbiased presentation.

Jennifer McVean, MD
Consulting fees/advisory boards: Mannkind Corporation, Medtronic, Inc.
Fees received for promotional/non-CME activities: Medtronic, Inc.

Marian Rewers, MD, PhD
Consulting fees/advisory boards: F. Hoffmann-La Roche Ltd., Janssen Pharmaceuticals, Inc., Provention Bio, United Health Group
Contracted research: Janssen Pharmaceuticals, Inc.

Jay H. Shubrook, DO, FACOFP, FAAFP, BC-ADM
Consulting fees/advisory boards: Bayer HealthCare Pharmaceuticals, Eli Lilly and Company, Novo Nordisk
The writer, peer reviewers, and other activity planners have no financial relationships to disclose.
Statement of Evidence-Based Content
Educational activities that assist physicians in carrying out their professional responsibilities more effectively and efficiently are consistent with the ACCME definition of continuing medical education (CME). As an ACCME-accredited provider of CME, Med-IQ has a policy to review and ensure that all the content and any recommendations, treatments, and manners of practicing medicine in CME activities are scientifically based, valid, and relevant to the practice of medicine. Med-IQ is responsible for validating the content of the CME activities it provides. Specifically, (1) all recommendations addressing the medical care of patients must be based on evidence that is scientifically sound and recognized as such within the profession; (2) all scientific research referred to, reported, or used in CME in support or justification of a patient care recommendation must conform to generally accepted standards of experimental design, data collection, and analysis.

Med-IQ is not liable for any decision made or action taken in reliance upon the information provided through this activity. 
Contact Information
For questions or comments about this activity, please contact Med-IQ. Call (toll-free) 866 858 7434 or email

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The information provided through this activity is for continuing education purposes only and is not meant to substitute for the independent medical judgment of a physician relative to diagnostic and treatment options of a specific patient’s medical condition.

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Complimentary CE
This activity is available free of charge to participants.

Acknowledgment of Commercial Support
This activity is supported by an educational grant from Provention Bio.
© 2021 JDRF

The following material has been developed to accompany this activity:

Talking to Patients and Families About T1D Risk and Screening Tests

Next Steps for Patients and Families After Screening for T1D Autoantibodies

Note: This material is not accredited for CME and, therefore, does not offer any CME/CE credit.


Here are the key takeaways from this activity. Deeper insights and evidence, plus an opportunity to receive credit, are available at the "Continue" button below.

  • Individuals with a first-degree relative with T1D have a greater risk of developing T1D compared with the general population
  • However, an estimated 93% of people diagnosed with T1D do not have a family history of T1D
  • T1D begins as beta-cell autoimmunity and progresses to clinical diabetes after months or years when individuals are still presymptomatic and normoglycemic
  • T1D is now categorized into 3 stages according to this pathophysiologic progression based on the presence of islet cell autoantibodies, glycemic control, and symptomatology with autoantibody development occurring before stage 1
  • T1D autoantibody screening is now available for the general population through national programs such as T1Detect and for individuals with an affected relative through TrialNet, as well as several local programs
  • These programs identify persons at risk of developing T1D to ensure that they receive education regarding symptoms of diabetes, follow-up care, and monitoring to detect clinical T1D earlier and prevent the occurrence of life-threatening DKA at diagnosis
  • Individuals who are positive for 2 or more T1D autoantibodies and individuals with new-onset T1D may be eligible for participation in a clinical trial for a disease-modifying therapy to slow the progression of T1D
  • A disease-modifying therapy is currently being evaluated for FDA approval to delay the progression of clinical T1D in individuals who have a high risk of developing T1D

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