Most diabetes care and education specialists follow guidance on type 1 diabetes screening
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Key takeaways:
- Most respondents to a small survey said they follow ADA recommendations for type 1 diabetes screening.
- One-third of respondents said they did not have knowledge about using teplizumab to delay type 1 diabetes.
Most diabetes care and education specialists said they believe it is important to screen for presymptomatic type 1 diabetes, though some said they had limited knowledge regarding teplizumab-mzwv, according to a presenter.
Researchers presented findings from a small cross-sectional survey focused on type 1 diabetes screening and prevention at the Association of Diabetes Care and Education Specialists annual meeting. Most respondents were neutral or agreed with the American Diabetes Association’s 2024 Standard of Care recommendations regarding type 1 diabetes staging and screening, and the majority agreed that they had knowledge of teplizumab-mzwv (Tzield, Provention Bio). However, Jennifer Clements, PharmD, FCCP, FADCES, BCPS, CDCES, BCACP, BC-ADM, clinical professor and director of pharmacy education at the University of South Carolina College of Pharmacy, said, some respondents were not confident with the use of teplizumab-mzwv and response to the survey was small.
“It would be great to have more real-world perspective on teplizumab,” Clements told Healio. “As individuals become more knowledgeable on the medication and perhaps gain clinical experience, it would be important to share best practices.”
Diabetes care and education specialists were invited to complete a 20-quesiton survey on the screening and staging of type 1 diabetes and the role of teplizumab-mzwv in treating presymptomatic type 1 diabetes. The survey was conducted over a 6-week period. After filling out demographic information, participants provided their response to statements on a 5-point Likert scale. Responses to each statement were strongly disagree, disagree, neutral, agree and strongly agree.
Of the 21 diabetes care and education specialists who completed the survey, 81% had 11 or more years of practice experience and 61.9% worked in ambulatory or outpatient care. Of the respondents, 61.9% said 25% or less of their patient population had type 1 diabetes. Twelve of the respondents said 76% or more of the patient population at their practice were adults.
The majority of respondents were neutral, agreed or strongly agreed that they promote screening for presymptomatic type 1 diabetes, stage individuals with type 1 diabetes based on their characteristics and diagnostic criteria, and suggest or make referrals to a specialized center for further evaluation based on the 2024 ADA Standards of Care. Eight respondents disagreed or strongly disagreed about referring patients to a specialized center.
“It was encouraging to see most respondents agreeing with the importance of type 1 diabetes screening,” Clements said. “The recommendations are clear and should be considered for implementation into clinical practice, regardless of the setting.”
Of the participants, 66.7% agreed or strongly agreed that they have the knowledge to support the role of teplizumab-mzwv to delay symptomatic type 1 diabetes, though 19% disagreed and 14.2% strongly disagreed with the statement. The responses were similar when participants were asked whether they had the knowledge to promote teplizumab-mzwv to delay type 1 diabetes among people aged 8 years and older with stage 2 type 1 diabetes.
“There was a small sample size, so it does not clearly determine if respondents are or are not familiar with teplizumab-mzwv,” Clements said. “However, there may be diabetes care and education specialists who have not gained clinical experience with this medication based on clinical setting, patient populations or other reasons.”
The majority of respondents agreed or strongly agreed that they understood statements about the need for two positive pancreatic islet antibodies to prescribe teplizumab-mzwv, the need for a complete blood count and liver enzyme tests, the administration of teplizumab-mzwv and the cost.
Clements said more information is needed to explain best practices for type 1 diabetes screening and teplizumab-mzwv use.
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Clements J, et al. P-218. Presented at: ADCES24; Aug, 9-12, 2024; New Orleans.
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