The unique clinical needs of the population have been addressed by a consensus statement on the management of type 1 diabetes in adults, which was published recently.
It is vastly different from the needs of children with type 1 diabetes or adults with type 2 diabetes.
Type 1 Diabetes In Adults Gets New Attention
The coauthor of the document, M. Sue Kirkman, said that the adult population has been forgotten about with regards to diabetes and that this new focus is quite important.
She added that it’s assumed that the diabetes people are talking about is type 2.
Diagnosis of type 1 diabetes, goals and targets, schedule of care, glucose monitoring, hypoglycemia, insulin therapy, self-management education and lifestyle, diabetic ketoacidosis, psychosocial care, adjunctive therapies, emergent and future perspectives, and pancreas transplant.
The final version of the joint ADA/EASD statement was presented on October 1 at the virtual European Association for the Study of Diabetes (EASD) 2021 during their Annual Meeting. This was done so after the draft form was initially presented in June at the American Diabetes Association (ADA) 81st Scientific Sessions.
It was also published in Diabetologia and Diabetes Care at the same time.
Richard IG Hold, the writing group co-chair said that they were aware of the multitude of rapid advances in the diagnosis and treatment of type 1 diabetes.
He has an MB Bichir, Ph.D.
At the University of Southampton, UK, he is also a professor of diabetes and endocrinology.
He added while introducing the 90-minute EASD session, that there is also a growing recognition of the burden on mental health that is added by living with type 1 diabetes, despite all these advances.
Even though there is guidance for the management of type 1 diabetes, he said that the aim of this report is to highlight the major areas that professionals in healthcare should pay attention to. This should be done while managing adults who have been diagnosed with type 1 diabetes.
At the briefing, Lori MB Laffel said that the previous guidelines were based on outdated information.
She added that the rates of hypoglycemia were not increased in the youngest patients.
Evidence of acute adverse central nervous system effects of hyperglycemia was shown by new research.
Holt said that there has been a huge influence by the joint EASD/ADA consensus report on type 2 diabetes.
He added that the need to develop a comparable consensus report was recognized by the EASD and ADA. Especially one that specifically addressed type 1 diabetes.
Holt said that the overriding goals were to support people who had type 1 diabetes and live a long and healthy life.
4 specific strategies were highlighted: in order to prevent complications while minimizing hypoglycemia and preventing DKA, insulin was delivered to keep glucose levels as close to the target as possible.
Other strategies are to manage cardiovascular risk factors, minimize psychosocial burden and promote psychological well-being.
J Hands DeVries, another coauthor explained that the recommended approach to differentiate between type 1 and type 2 diabetes is a clinical challenge.
Most of the questions during the EASD session were prompted by this particular topic.
DeVries said that misdiagnosis, especially in adults, is very common. He added that in patients over the age of 30, it occurs in almost 40% of them.
C peptide levels and a reflection of endogenous insulin secretion are some of the many reasons for the confusion.
The secretion of insulin can still be very high at the time of clinical onset of type 1 diabetes.
Antibodies of islets do not have a 100% positive predictive value.
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