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Risk Factors and Prevention Strategies in Patients with Type 1 Diabetes

Donika Kandilarova

Abstract

Type 1 diabetes is one of the most rapidly spreading chronic autoimmune diseases, characterized by beta-cell destruction leading to insulin deficiency and hyperglycemia. Early identification of individuals with type 1 diabetes in the presymptomatic phase can predict clinical disease and improve health outcomes.

Aim: The aim of this review is to focus on risk factors and prevention strategies in patients with type 1 diabetes.

Material and Мethods: A review and systematic search were conducted in the PubMed database using the keywords: type 1 diabetes, risk factors, prevention. The search covered the last 10 years, from 2014 to 2024, and included the full text of available scientific reports from which this review was prepared.

Results: The study identified 17 systematic reviews that met the inclusion criteria out of a total of 614 results retrieved using the specified keywords.

Discussion: Several risk factors for the development of type 1 diabetes mellitus have been identified, including genetic predisposition, family history, environmental factors, and metabolic biomarkers. Prevention strategies—primary, secondary, and tertiary—are important to stop the natural progression of the disease and identify high-risk individuals.

Conclusion: The continuing global prevalence of diabetes represents a significant public health challenge. Accurate identification and characterization of populations at the highest risk are key to developing successful strategies for prevention, prophylaxis, and management of the disease. Predicting risk factors and implementing prevention strategies are important future steps in the treatment and control of the disease.


Keywords

type 1 diabetes, risk factors, prevention

Full Text


References

Home, Resources, diabetes L with, Acknowledgement, FAQs, Contact, et al. IDF Diabetes Atlas 2021 | IDF Diabetes Atlas [Internet]. [cited 2024 Jun 3]. Available from: https://diabetesatlas.org/atlas/tenth-edition/

Ebbesson SO, Schraer CD, Risica PM, Adler AI, Ebbesson L, Mayer AM, et al. Diabetes and impaired glucose tolerance in three Alaskan Eskimo populations. The Alaska-Siberia Project. Diabetes Care. 1998 Apr;21(4):563–9.

Zimmet P, Alberti KG, Shaw J. Global and societal implications of the diabetes epidemic. Nature. 2001 Dec 13;414(6865):782–7.

Motala AA, Omar MAK, Pirie FJ. Diabetes in Africa. Epidemiology of type 1 and type 2 diabetes in Africa. J Cardiovasc Risk. 2003 Apr;10(2):77–83.

Nyenwe EA, Odia OJ, Ihekwaba AE, Ojule A, Babatunde S. Type 2 diabetes in adult Nigerians: a study of its prevalence and risk factors in Port Harcourt, Nigeria. Diabetes Res Clin Pract. 2003 Dec;62(3):177–85.

Engelgau MM, Geiss LS, Saaddine JB, Boyle JP, Benjamin SM, Gregg EW, et al. The evolving diabetes burden in the United States. Ann Intern Med. 2004 Jun 1;140(11):945–50.

Георгиева Б, Панчева Р, Ушева Н, Главчева С, Йотов Йото, Бочева Я, et al. Препоръки за хранене и хранителни предизвикателства при пациенти със захарен диабет тип 1. Наука Ендокринология. 2018;

Simmons KM, Sims EK. Screening and Prevention of Type 1 Diabetes: Where Are We? J Clin Endocrinol Metab. 2023 Nov 17;108(12):3067–79.

GBD 2021 Diabetes Collaborators. Global, regional, and national burden of diabetes from 1990 to 2021, with projections of prevalence to 2050: a systematic analysis for the Global Burden of Disease Study 2021. Lancet. 2023 Jul 15;402(10397):203–34.

Ehrmann D, Kulzer B, Roos T, Haak T, Al-Khatib M, Hermanns N. Risk factors and prevention strategies for diabetic ketoacidosis in people with established type 1 diabetes. Lancet Diabetes Endocrinol. 2020 May;8(5):436–46.

Танкова Цветелина. Рискови фактори за захарен диабет. Наука Ендокринология. 2007;

Rogers MAM, Kim C, Banerjee T, Lee JM. Fluctuations in the incidence of type 1 diabetes in the United States from 2001 to 2015: a longitudinal study. BMC Med. 2017 Nov 8;15(1):199.

Forga Llenas L, Goñi Iriarte MJ, Cambra Contin K, Ibáñez Beroiz B, Chueca Guendulain M, Berrade Zubiri S. Incidence and temporal trends of childhood type 1 diabetes between 1975 and 2012 in Navarre (Spain). Gac Sanit. 2015;29(1):51–4.

Home, Resources, diabetes L with, Acknowledgement, FAQs, Contact, et al. IDF Diabetes Atlas [Internet]. [cited 2024 Jan 13]. Available from: https://diabetesatlas.org/

Rg M, Am S, Rk S, Tj S, Tj O. Improvements in the life expectancy of type 1 diabetes: the Pittsburgh Epidemiology of Diabetes Complications study cohort. Diabetes [Internet]. 2012 Nov [cited 2024 Jan 20];61(11). Available from: https://pubmed.ncbi.nlm.nih.gov/22851572/

Mobasseri M, Shirmohammadi M, Amiri T, Vahed N, Hosseini Fard H, Ghojazadeh M. Prevalence and incidence of type 1 diabetes in the world: a systematic review and meta-analysis. Health Promot Perspect. 2020 Mar 30;10(2):98–115.

Shields BM, Peters JL, Cooper C, Lowe J, Knight BA, Powell RJ, et al. Can clinical features be used to differentiate type 1 from type 2 diabetes? A systematic review of the literature. BMJ Open. 2015 Nov 2;5(11):e009088.

CDC. Centers for Disease Control and Prevention. 2023 [cited 2024 Jan 21]. Diabetes Symptoms. Available from: https://www.cdc.gov/diabetes/basics/symptoms.html

Neu A, Hofer SE, Karges B, Oeverink R, Rosenbauer J, Holl RW, et al. Ketoacidosis at diabetes onset is still frequent in children and adolescents: a multicenter analysis of 14,664 patients from 106 institutions. Diabetes Care. 2009 Sep;32(9):1647–8.

Dhatariya KK, Nunney I, Higgins K, Sampson MJ, Iceton G. National survey of the management of Diabetic Ketoacidosis (DKA) in the UK in 2014. Diabet Med. 2016 Feb;33(2):252–60.

Schober E, Rami B, Waldhoer T, Austrian Diabetes Incidence Study Group. Diabetic ketoacidosis at diagnosis in Austrian children in 1989-2008: a population-based analysis. Diabetologia. 2010 Jun;53(6):1057–61.

Dabelea D, Rewers A, Stafford JM, Standiford DA, Lawrence JM, Saydah S, et al. Trends in the prevalence of ketoacidosis at diabetes diagnosis: the SEARCH for diabetes in youth study. Pediatrics. 2014 Apr;133(4):e938-945.

Noble JA. Immunogenetics of type 1 diabetes: A comprehensive review. J Autoimmun. 2015 Nov;64:101–12.

Taylor SI, Blau JE, Rother KI, Beitelshees AL. SGLT2 inhibitors as adjunctive therapy for type 1 diabetes: balancing benefits and risks. Lancet Diabetes Endocrinol. 2019 Dec;7(12):949–58.

So M, Speake C, Steck AK, Lundgren M, Colman PG, Palmer JP, et al. Advances in Type 1 Diabetes Prediction Using Islet Autoantibodies: Beyond a Simple Count. Endocr Rev. 2021 Sep 28;42(5):584–604.

Oram RA, Redondo MJ. New insights on the genetics of type 1 diabetes. Curr Opin Endocrinol Diabetes Obes. 2019 Aug;26(4):181–7.

Sims EK, DiMeglio LA. Cause or effect? A review of clinical data demonstrating beta cell dysfunction prior to the clinical onset of type 1 diabetes. Mol Metab. 2019 Sep;27S(Suppl):S129–38.

Hull CM, Peakman M, Tree TIM. Regulatory T cell dysfunction in type 1 diabetes: what’s broken and how can we fix it? Diabetologia. 2017;60(10):1839–50.

Rewers M, Ludvigsson J. Environmental risk factors for type 1 diabetes. Lancet. 2016 Jun 4;387(10035):2340–8.

Handelsman Y, Henry RR, Bloomgarden ZT, Dagogo-Jack S, DeFronzo RA, Einhorn D, et al. AMERICAN ASSOCIATION OF CLINICAL ENDOCRINOLOGISTS AND AMERICAN COLLEGE OF ENDOCRINOLOGY POSITION STATEMENT ON THE ASSOCIATION OF SGLT-2 INHIBITORS AND DIABETIC KETOACIDOSIS. Endocr Pract. 2016 Jun;22(6):753–62.

Krogvold L, Edwin B, Buanes T, Frisk G, Skog O, Anagandula M, et al. Detection of a low-grade enteroviral infection in the islets of langerhans of living patients newly diagnosed with type 1 diabetes. Diabetes. 2015 May;64(5):1682–7.

Danne T, Garg S, Peters AL, Buse JB, Mathieu C, Pettus JH, et al. International Consensus on Risk Management of Diabetic Ketoacidosis in Patients With Type 1 Diabetes Treated With Sodium-Glucose Cotransporter (SGLT) Inhibitors. Diabetes Care. 2019 Jun;42(6):1147–54.

Garg SK, Peters AL, Buse JB, Danne T. Strategy for Mitigating DKA Risk in Patients with Type 1 Diabetes on Adjunctive Treatment with SGLT Inhibitors: A STICH Protocol. Diabetes Technol Ther. 2018 Sep;20(9):571–5.

The Environmental Determinants of Diabetes in the Young (TEDDY) Web Site [Internet]. [cited 2024 Jan 31]. Available from: https://teddy.epi.usf.edu/TEDDY/index.htm

Garrett CJ, Choudhary P, Amiel SA, Fonagy P, Ismail K. Recurrent diabetic ketoacidosis and a brief history of brittle diabetes research: contemporary and past evidence in diabetic ketoacidosis research including mortality, mental health and prevention. Diabet Med. 2019 Nov;36(11):1329–35.

Kalscheuer H, Seufert J, Lanzinger S, Rosenbauer J, Karges W, Bergis D, et al. Event Rates and Risk Factors for the Development of Diabetic Ketoacidosis in Adult Patients With Type 1 Diabetes: Analysis From the DPV Registry Based on 46,966 Patients. Diabetes Care. 2019 Mar;42(3):e34–6.

Fritsch M, Rosenbauer J, Schober E, Neu A, Placzek K, Holl RW, et al. Predictors of diabetic ketoacidosis in children and adolescents with type 1 diabetes. Experience from a large multicentre database. Pediatr Diabetes. 2011 Jun;12(4 Pt 1):307–12.

Everett E, Mathioudakis N. Association of Area Deprivation and Diabetic Ketoacidosis Readmissions: Comparative Risk Analysis of Adults vs Children With Type 1 Diabetes. J Clin Endocrinol Metab. 2019 Aug 1;104(8):3473–80.

Krischer JP, Lynch KF, Schatz DA, Ilonen J, Lernmark Å, Hagopian WA, et al. The 6 year incidence of diabetes-associated autoantibodies in genetically at-risk children: the TEDDY study. Diabetologia. 2015 May;58(5):980–7.

Parikka V, Näntö-Salonen K, Saarinen M, Simell T, Ilonen J, Hyöty H, et al. Early seroconversion and rapidly increasing autoantibody concentrations predict prepubertal manifestation of type 1 diabetes in children at genetic risk. Diabetologia. 2012 Jul 1;55(7):1926–36.

Ziegler AG, Bonifacio E, BABYDIAB-BABYDIET Study Group. Age-related islet autoantibody incidence in offspring of patients with type 1 diabetes. Diabetologia. 2012 Jul;55(7):1937–43.

Steck AK, Vehik K, Bonifacio E, Lernmark A, Ziegler AG, Hagopian WA, et al. Predictors of Progression From the Appearance of Islet Autoantibodies to Early Childhood Diabetes: The Environmental Determinants of Diabetes in the Young (TEDDY). Diabetes Care. 2015 May;38(5):808–13.

Ng K, Anand V, Stavropoulos H, Veijola R, Toppari J, Maziarz M, et al. Quantifying the utility of islet autoantibody levels in the prediction of type 1 diabetes in children. Diabetologia. 2023;66(1):93–104.

Bottazzo GF, Florin-Christensen A, Doniach D. Islet-cell antibodies in diabetes mellitus with autoimmune polyendocrine deficiencies. Lancet. 1974 Nov 30;2(7892):1279–83.

Palmer JP, Asplin CM, Clemons P, Lyen K, Tatpati O, Raghu PK, et al. Insulin antibodies in insulin-dependent diabetics before insulin treatment. Science. 1983 Dec 23;222(4630):1337–9.

Purcell AW, Sechi S, DiLorenzo TP. The Evolving Landscape of Autoantigen Discovery and Characterization in Type 1 Diabetes. Diabetes. 2019 May;68(5):879–86.

Umpierrez G, Korytkowski M. Diabetic emergencies - ketoacidosis, hyperglycaemic hyperosmolar state and hypoglycaemia. Nat Rev Endocrinol. 2016 Apr;12(4):222–32.

Dhatariya KK. Defining and characterising diabetic ketoacidosis in adults. Diabetes Res Clin Pract. 2019 Sep;155:107797.

Dhatariya KK, Umpierrez GE. Guidelines for management of diabetic ketoacidosis: time to revise? Lancet Diabetes Endocrinol. 2017 May;5(5):321–3.

Wolfsdorf JI, Glaser N, Agus M, Fritsch M, Hanas R, Rewers A, et al. ISPAD Clinical Practice Consensus Guidelines 2018: Diabetic ketoacidosis and the hyperglycemic hyperosmolar state. Pediatr Diabetes. 2018 Oct;19 Suppl 27:155–77.

Kulmala P, Savola K, Petersen JS, Vähäsalo P, Karjalainen J, Löppönen T, et al. Prediction of insulin-dependent diabetes mellitus in siblings of children with diabetes. A population-based study. The Childhood Diabetes in Finland Study Group. J Clin Invest. 1998 Jan 15;101(2):327–36.

Ziegler AG, Rewers M, Simell O, Simell T, Lempainen J, Steck A, et al. Seroconversion to multiple islet autoantibodies and risk of progression to diabetes in children. JAMA. 2013 Jun 19;309(23):2473–9.

Steck AK, Vehik K, Bonifacio E, Lernmark A, Ziegler AG, Hagopian WA, et al. Predictors of Progression From the Appearance of Islet Autoantibodies to Early Childhood Diabetes: The Environmental Determinants of Diabetes in the Young (TEDDY). Diabetes Care. 2015 May;38(5):808–13.

Semenkovich K, Berlin KS, Ankney RL, Klages KL, Keenan ME, Rybak TM, et al. Predictors of diabetic ketoacidosis hospitalizations and hemoglobin A1c among youth with Type 1 diabetes. Health Psychol. 2019 Jul;38(7):577–85.

Diabetic ketoacidosis (DKA) in Birmingham, UK, 2000—2009: an evaluation of risk factors for recurrence and mortality - Jennifer Wright, Katie Ruck, Roberta Rabbitts, Mary Charlton, Parijat De, Tim Barrett, Varadarajan Baskar, Christine Kotonya, Sanjay Saraf, Parth Narendran, 2009 [Internet]. [cited 2024 Jul 14]. Available from: https://journals.sagepub.com/doi/abs/10.1177/1474651409353248

Snoek FJ, Bremmer MA, Hermanns N. Constructs of depression and distress in diabetes: time for an appraisal. The Lancet Diabetes & Endocrinology. 2015 Jun 1;3(6):450–60.

Young-Hyman D, de Groot M, Hill-Briggs F, Gonzalez JS, Hood K, Peyrot M. Psychosocial Care for People With Diabetes: A Position Statement of the American Diabetes Association. Diabetes Care. 2016 Dec;39(12):2126–40.

Barski L, Eshkoli T, Brandstaetter E, Jotkowitz A. Euglycemic diabetic ketoacidosis. Eur J Intern Med. 2019 May;63:9–14.

Nyenwe EA, Loganathan RS, Blum S, Ezuteh DO, Erani DM, Wan JY, et al. Active use of cocaine: an independent risk factor for recurrent diabetic ketoacidosis in a city hospital. Endocr Pract. 2007;13(1):22–9.

Realsen J, Goettle H, Chase HP. Morbidity and mortality of diabetic ketoacidosis with and without insulin pump care. Diabetes Technol Ther. 2012 Dec;14(12):1149–54.

Jefferies CA, Nakhla M, Derraik JGB, Gunn AJ, Daneman D, Cutfield WS. Preventing Diabetic Ketoacidosis. Pediatr Clin North Am. 2015 Aug;62(4):857–71.

Goueslard K, Petit JM, Cottenet J, Chauvet-Gelinier JC, Jollant F, Quantin C. Increased Risk of Rehospitalization for Acute Diabetes Complications and Suicide Attempts in Patients With Type 1 Diabetes and Comorbid Schizophrenia. Diabetes Care. 2018 Nov;41(11):2316–21.

Baumeister H, Hutter N, Bengel J. Psychological and pharmacological interventions for depression in patients with diabetes mellitus and depression. Cochrane Database Syst Rev. 2012 Dec 12;12:CD008381.

Wong-Rieger D, Rieger FP. Health coaching in diabetes: empowering patients to self-manage. Can J Diabetes. 2013 Feb;37(1):41–4.




DOI: http://dx.doi.org/10.14748/vmf.v13i1.10158

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