Sanjoy Dutta | PubMed Health

PubMed2026

International consensus guidance for general population screening for islet autoantibodies to diagnose early-stage type 1 diabetes: a nominal group technique process.

Type 1 diabetes is an autoimmune disease that targets and destroys insulin-producing beta cells in the pancreatic islets. The incidence of type 1 diabetes is rising globally. At the clinical diagnosis of type 1 diabetes, between 20% and 67% of children and adolescents present with diabetic ketoacidosis (DKA) requiring hospitalisation, and one-third of these require intensive care. Type 1 diabetes can be detected in early stages, prior to the insulin-requiring clinical diagnosis, through screening for islet autoantibodies (IAbs). Identifying individuals with early-stage type 1 diabetes, combined with monitoring of and education on disease progression, prevents DKA and results in a milder clinical onset. This allows for timely insulin initiation in outpatient settings and improved long-term glucose management. Early diagnosis also enables access to novel disease-modifying therapies that can delay the clinical onset of diabetes. In this international consensus, we provide guidance on the principles and practice of implementing general population screening for IAbs to diagnose early-stage type 1 diabetes. We also outline the minimum requirements for establishing effective population screening programmes to diagnose early-stage type 1 diabetes through IAb detection. This consensus statement has been endorsed by the following professional associations: Advanced Technologies & Treatments for Diabetes (ATTD); Association of Diabetes Care and Education Specialists (ADCES); Association Belge Du Diabète; Associazione Medici Diabetologi (AMD); Australian Diabetes Society (ADS); Belgian Diabetes Liga; Breakthrough T1D; Czech Diabetes Society (ČDS); EASD; Finnish Diabetes Association (FDS); Fondazione Italiana Diabete (FID); International Diabetes Federation (IDF)-Europe; International Society of Paediatric and Adolescent Diabetes (ISPAD); Paediatric Endocrinology Nursing Society (PENS); Polish Diabetes Society; Portuguese Diabetes Association (APDP); Sociedade Portuguesa de Diabetologia (SPD); Società Italiana di Diabetologia (SID); Société Francophone du Diabète (SFD) and Type 1 Diabetes Exchange (T1D Exchange).

Consensus report↗

PubMed2002

Pdx1 restores beta cell function in Irs2 knockout mice.

The homeodomain transcription factor Pdx1 is required for pancreas development, including the differentiation and function of beta cells. Mutations in Pdx1 or upstream hepatocyte nuclear factors cause autosomal forms of early-onset diabetes (maturity-onset diabetes of the young [MODY]). In mice, the Irs2 branch of the insulin/Igf signaling system mediates peripheral insulin action and pancreatic beta cell growth and function. To investigate whether beta cell failure in Irs2(-/-) mice might be related to dysfunction of MODY-related transcription factors, we measured the expression of Pdx1 in islets from young Irs2(-/-) mice. Before the onset of diabetes, Pdx1 was reduced in islets from Irs2(-/-) mice, whereas it was expressed normally in islets from wild-type or Irs1(-/-) mice, which do not develop diabetes. Whereas male Irs2(-/-)Pdx1(+/+) mice developed diabetes between 8 and 10 weeks of age, haploinsufficiency for Pdx1 caused diabetes in newborn Irs2(-/-) mice. By contrast, transgenic expression of Pdx1 restored beta cell mass and function in Irs2(-/-) mice and promoted glucose tolerance throughout life, as these mice survived for at least 20 months without diabetes. Our results suggest that dysregulation of Pdx1 might represent a common link between ordinary type 2 diabetes and MODY.

Animals↗