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儿童 1 型糖尿病的自身抗体检测:在普通人群中实施筛查计划是否有理由?这是意大利儿科内分泌学会和糖尿病学会(SIEDP-ISPED)和意大利儿科学会(SIP)认可的声明。

Autoantibody test for type 1 diabetes in children: are there reasons to implement a screening program in the general population? A statement endorsed by the Italian Society for Paediatric Endocrinology and Diabetes (SIEDP-ISPED) and the Italian Society of Paediatrics (SIP).

机构信息

Department of Women's and Children's Health, Salesi Hospital, Ancona, Italy.

Department of Paediatrics, University of Chieti, Via dei Vestini, 5, I-66100, Chieti, Italy.

出版信息

Ital J Pediatr. 2023 Jul 19;49(1):87. doi: 10.1186/s13052-023-01438-3.

Abstract

In recent years screening of type 1 diabetes (T1D) in both at risk children and general population has been widely discussed with the aim of increasing awareness of the importance to early detect (and possibly treat) at-risk children in early stages of the chronic autoimmune progression to T1D.In fact, it is well known that first-degree relatives have the highest risk of T1D, but up to 90% of children who develop T1D do not have a family history and belong to the general population.The reasons for screening children well before the clinical onset of T1D include prevention of DKA (still up to 60% children are diagnosed with DKA) and related morbidities and mortality, reducing the need for hospitalisation, time to provide emotional support and education to ensure a smooth transition to insulin treatment, and opportunities for new treatments to prevent or delay progression.There are pros and cons of screening of T1D in children, but recent evidences suggest that it is now time to consider possible a screening for T1D in children.Recently, the European Society for Paediatric Endocrinology (ESPE) has endorsed a Position Statement, discussing the pros and cons of screening for T1D in the general population; ESPE supports national Societies for Paediatric Endocrinology to spread information on this important issue in various countries throughout Europe; the Italian Society for Paediatric Endocrinology and Diabetes (SIEDP-ISPED) and the Italian Society of Paediatrics (SIP) endorse this document with the specific aim of increasing awareness on screening for paediatric T1D in the general population.

摘要

近年来,1 型糖尿病(T1D)的筛查在高危儿童和普通人群中得到了广泛讨论,目的是提高人们对早期发现(和可能治疗)高危儿童的认识,因为这些儿童正处于 T1D 慢性自身免疫进展的早期阶段。事实上,众所周知,一级亲属患 T1D 的风险最高,但高达 90%的 T1D 患儿没有家族史,属于普通人群。在 T1D 临床发病前对儿童进行筛查的原因包括预防糖尿病酮症酸中毒(仍有高达 60%的患儿被诊断为糖尿病酮症酸中毒)和相关的发病率和死亡率、减少住院需求、为提供情感支持和教育以确保顺利过渡到胰岛素治疗留出时间,以及为预防或延缓进展提供新治疗方法的机会。T1D 儿童筛查有利有弊,但最近的证据表明,现在是时候考虑在儿童中进行 T1D 筛查了。最近,欧洲儿科内分泌学会(ESPE)发布了一份立场声明,讨论了在普通人群中筛查 T1D 的利弊;ESPE 支持各国儿科内分泌学会在欧洲各国传播有关这一重要问题的信息;意大利儿科内分泌学会和糖尿病学会(SIEDP-ISPED)和意大利儿科学会(SIP)赞同这份文件,其具体目标是提高对普通人群中儿童 T1D 筛查的认识。

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