The Time is NOW: Incorporating T1D Screening and Treatment Options into DSMES

Webinar Slides

Pdf Summary

The document is a webinar slide deck on integrating type 1 diabetes (T1D) screening, staging, monitoring, and emerging therapies into Diabetes Self-Management Education and Support (DSMES). It reviews diabetes types and emphasizes that T1D is an autoimmune, progressive loss of pancreatic beta cells, moving through presymptomatic stages before clinical diagnosis. Key objectives include identifying the three stages of T1D, recognizing symptoms across stages, understanding who/why/how to screen, and discussing new immune-modulating treatment options such as teplizumab (Tzield), which is indicated to delay onset of Stage 3 T1D in patients aged 8+ with Stage 2 disease.<br /><br />Screening is presented as urgent because it can reduce diabetic ketoacidosis (DKA) at diagnosis (reported up to 62%), avoid misdiagnosis (especially in adults frequently labeled as type 2), enable earlier insulin planning, support research enrollment, and identify candidates for interventions to delay progression. Progression from Stage 2 to Stage 3 is common (about 60% within 2 years; 75% within 4–5 years; near 100% lifetime).<br /><br />Who to screen includes relatives of people with T1D (first-degree relatives have ~15x risk), individuals with autoimmune conditions (e.g., thyroid disease, celiac), and people with atypical diabetes presentations or poor response to type 2 therapies. Screening involves islet autoantibodies (IAA, GAD, IA-2A, ZnT8) via clinical labs or programs such as TrialNet and other kits; guidance is provided for rescreening and monitoring (A1c, OGTT, meter, CGM) in children and adults.<br /><br />A major focus is “operationalizing” T1D screening within the six 2022 DSMES National Standards: building stakeholder networks and referral pathways, ensuring team competency and updated materials (including new ICD-10 staging codes), embedding screening/staging content into DSMES curriculum areas (pathophysiology, medications, monitoring, complications, coping), supporting behavioral health needs, and tracking outcomes and CQI projects related to screening, staging, referrals, and therapy uptake.

Keywords

type 1 diabetes screening

T1D staging (Stage 1, Stage 2, Stage 3)

islet autoantibodies (GAD, IAA, IA-2A, ZnT8)

Diabetes Self-Management Education and Support (DSMES)

teplizumab (Tzield) immune-modulating therapy

diabetic ketoacidosis prevention at diagnosis

TrialNet screening program

monitoring progression (A1c, OGTT, CGM)

ICD-10 codes for T1D staging

2022 DSMES National Standards implementation