1516-P: EMR-Based Insights Into T1D Screening Patient Volume

• Published in: Diabetes (New York, N.Y.) Vol. 74; no. Supplement_1; p. 1
• Main Authors: KHINE, AYE H., PARK, RYAN, GITELMAN, STEPHEN E., QUANDT, ZOE
• Format: Journal Article
• Language: English
• Published: New York American Diabetes Association 20.06.2025
• Subjects: Autoantibodies; Celiac disease; Diabetes mellitus (insulin dependent); Electronic medical records; Graves disease; Hashimoto's thyroiditis; Hemoglobin; Thyroid diseases; Thyroid gland; Thyroiditis; Transglutaminase 2; Trisomy
• ISSN: 0012-1797; 1939-327X
• DOI: 10.2337/db25-1516-P

Introduction and Objective: With the approval of teplizumab for stage 2 type 1 diabetes (T1D), widespread islet autoantibody (IA) screening is increasingly important. We estimated the size of groups at higher risk for T1D and projected IA positivity rates within the UCSF electronic medical record (EMR). Methods: Using de-identified EMR data, we identified patients of all ages without a hemoglobin A1C (A1c) ≥6.5% nor an insulin prescription, meeting criteria for: (1) “Lean prediabetes”: BMI ≤23 kg/m2, A1c 5.7-6.4% (2) Celiac disease: ICD10 code or autoantibody (tissue transglutaminase, antigliadin) (3) Autoimmune thyroid disease: ICD10 code or thyroid autoantibodies for Graves’ and Hashimoto’s thyroiditis (4) Trisomy 21 (T21): ICD10 code. We used descriptive statistics to quantify group sizes and estimate IA positivity rates from published literature. Results: Among 1,046,734 patients, we identified 12,241 with lean prediabetes, 5,996 with celiac disease, 16,627 with Graves’ disease, 94,752 with Hashimoto’s thyroiditis, and 5,082 with T21. The number of IA positive patients is estimated as: 228 for celiac disease, 515 for Graves’ disease, 9,001 for Hashimoto’s thyroiditis, and 36 for T21. No estimate was available for lean prediabetes. Conclusion: Targeted screening identified up to 134,698 eligible patients, with up to 9,780 estimated to test positive for IAs, representing a large opportunity to identify teplizumab candidates at risk for T1D.