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Endocrine & Diabetic Disease States

We recognize the challenges of caring for patients with complex endocrine disorders. From diabetes to rare disorders, we believe in supporting you as you care for all of your endocrine patients.

Type 1 Diabetes

Type 1 Diabetes

An opportunity to improve patient care

We believe early identification of Type 1 Diabetes can significantly improve patient care—and Labcorp can provide the answers you need. 

T1D is an autoimmune disease characterized by the body’s attack on pancreatic β-cells that eventually leads to inability to produce insulin. As a result, T1D can progress silently—for months or even years before the onset of symptoms. Patients at-risk for clinical T1D may not be aware of their condition, which is often associated with family history and genetic factors. Patients can learn more about Type 1 Diabetes here.

Research shows that at least 1.6 million people in the U.S.  1(18 million globally) live with T1D, and the prevalence is increasing. Another estimated 300K people are at increased risk2 of clinical T1D in the U.S.

T1D 101: What to Know

T1D Signs & Symptoms

While people with diabetes may have mild symptoms, some common symptoms can include3:

  • Frequent urination (or unexpected bed-wetting in children)
  • Increased thirst
  • Feeling hungry or weight loss, despite eating
  • Extreme fatigue and weakness
  • Blurry vision
  • Slow healing of cuts/bruises

Often times warning signs and symptoms of T1D may be missed, and many patients end up diagnosed in the hospital suffering from severe hyperglycemia or even diabetic ketoacidosis.

Understanding diabetic ketoacidosis (DKA)

T1D typically causes elevated blood glucose levels, which can lead to life-threatening diabetic ketoacidosis (DKA). DKA is a serious condition4 that can lead to “metabolic scarring,” a diabetic coma or even death as ketones build up in the bloodstream due to insufficient insulin production.5 This metabolic scarring is associated with lower residual β-cell function, higher HbA1c for up to 15 years, and even rare neurological trauma. Up to 50% of children experience DKA at onset of T1D.5

T1D Screening & DKA

Measuring antibodies in people at high-risk of developing T1D allows for increased education and vigilance. This can help patients, their loved ones, and clinicians recognize symptoms sooner. By increasing awareness, you may improve outcomes5 for your patients and help them reduce the incidence of DKA at diagnosis by >50 percent.

T1D Screening Recommendations

The American Diabetes Association advises that physicians may offer T1D screening6 to any first-degree relatives of T1D patients. Research conducted7 of current screening practices found that over half (58%) of the surveyed endocrinologists order autoantibody testing for the family members of their T1D patients.

Learn About Labcorp’s Screening Option for T1D

Together, let’s provide the best possible care for T1D patients.

After Diagnosis: What’s Next?

There are no currently approved treatments to delay symptom onset for patients. It can be helpful after diagnosis to have a discussion with your patient about how to prevent DKA and how to manage T1D complications. 

Your T1D patients can be at risk for other autoimmune diseases, therefore, it may be beneficial to screen for thyroid disease soon after T1D diagnosis and every one to two years thereafter, or sooner if symptoms present. Screening for celiac disease is also recommended when gastrointestinal symptoms exist, or laboratory manifestations suggestive of celiac disease are present.6

Patient Resource Groups

We recommend connecting your T1D patients with many active resource groups online—such as JDRF, Taking Control of your Diabetes (TCOYD) and Beyond Type 1—and encouraging your patients to consider upcoming or current clinical trials posted on TrialNet, as many promising studies are examining novel methods to delay the onset of T1D.

Labcorp Resources for Patients

We’re proud to be your laboratory service provider and want to help answer questions your patients may have, and help them navigate life with T1D. Send your patients to our new T1D resource center.

NAFLD/NASH in endocrine patients

NAFLD/NASH in endocrine patients

Evidence shows that between 50-70% of patients with type 2 diabetes have non-alcoholic fatty liver disease (NAFLD), and approximately 6.4 million diabetics are believed to have non-alcoholic steatohepatitis (NASH). Type 2 diabetes increases the progression of NAFLD to the more serious condition of NASH, putting patients at a higher risk for cirrhosis and hepatocellular carcinoma.

Beyond the impact to the liver, NAFLD has also been associated with an increase in other diabetic complications, including both micro- and macro-vascular complications. Patients may exhibit higher levels of insulinemia; they also may experience hyperglycemia that is difficult to control.

How will screening impact patient care? Many publications speak to the prevalence of NAFLD and NASH in type 2 diabetes and the importance of screening, including this recent article from Diabetes Care regarding screening and management of type 2 diabetic patients with NASH.

Research also shows polycystic ovary syndrome (PCOS) patients, even those with a normal BMI, have an increased incidence of NAFLD, a potential NASH precursor. PCOS and NAFLD share many risk factors for NAFLD. Furthermore, androgen excess may be a risk factor contributing to NAFLD.

Read more about the risk factors associated with NAFLD in PCOS.

Want to Learn More About NASH?

NASH is a form of fatty liver disease. According to researchers, one in four people is affected by fatty liver disease, which can develop for a number of reasons.

Polycystic Ovary Syndrome (PCOS)

Polycystic Ovary Syndrome (PCOS)

PCOS is the most common endocrine disorder among reproductive-age women, affecting as many as 5 million US women, and an estimated 75% may be undiagnosed. PCOS may begin soon after the first menstrual period and is often diagnosed when women have difficulty getting pregnant. Guidelines recommend assessing androgen excess and ruling out other disorders. To assist providers in navigating diagnoses of PCOS, we offer a PCOS panel based on recommendations from multiple societies

PCOS is increasingly being recognized as a lifelong metabolic disorder associated with obesity, insulin resistance, metabolic syndrome, type 2 diabetes and NAFLD. We have a full compendium of testing to support patient care after diagnosis.

Learn more
Prediabetes

Prediabetes

There are an estimated 84 million adults 18 years and older in the U.S. who are prediabetic or at risk for developing diabetes.11 Prediabetes is characterized as higher than normal glucose levels but not high enough to meet criteria for diabetes.12 

Risk Assessment Testing for Providers
Prediabetes Risk Assessment for Providers
Prediabetes Information for Patients

References

  1.  Centers for Disease Control and Prevention. National diabetes statistics report, 2020. Atlanta, GA: Centers for Disease Control and Prevention, U.S. Dept of Health and Human Services. 2020.
     
  2.  Modeling the total economic value of novel type 1 diabetes (T1D) therapeutic concepts. JDRF T1D Fund; 2020.
     
  3. Diabetes symptoms. American Diabetes Association website. Accessed July 15, 2021. https://www.diabetes.org/diabetes/type-1/symptoms
     
  4. DKA (ketoacidosis) & ketones. American Diabetes Association website. Accessed July 15, 2021. https://www.diabetes.org/diabetes/complications/dka-ketoacidosis-ketones
     
  5. Screening can reduce DKA at onset by ≥50%. Provention Bio, Inc. website. Accessed July 15, 2021. https://connectedbyt1d.com/proactive-screening
     
  6. Classification and diagnosis of diabetes: standards of medical care in diabetes—2021 American Diabetes Association. Diabetes Care. Jan 2021, 44 (Supplement 1) S15-S33; DOI: 10.2337/dc21-S002
     
  7. Fieldwork research performed in January 2021 to survey 100 U.S. endocrinologists across private settings, community practices and academic centers.
     
  8. Simmons, KM, Steck, AK. Islet autoantibody testing. Current utility, future prospects in predicting and diagnosing type 1 diabetes. Clinical Laboratory News. 2017 Jul 1.
     
  9. Wenzlau JM, Juhl K, Yu L, et al. The cation efflux transporter ZnT8 (Slc30A8) is a major autoantigen in human type 1 diabetes. Proc Natl Acad Sci U S A. 2007;104(43):17040-17045. doi:10.1073/pnas.070589410
     
  10. Thomas NJ, Jones SE, Weedon MN, Shields BM, Oram RA, Hattersley AT. Frequency and phenotype of type 1 diabetes in the first six decades of life: a cross-sectional, genetically stratified survival analysis from UK Biobank.
     
  11. National Diabetes Statistics Report, 2017. National Center for Chronic Disease Prevention and Health Promotion, Center for Disease Control. Pages 1-20
     
  12. Standards of Medical Care in Diabetes Care – 2018. American Diabetes Association. Diabetes Care 2018;41:S1-S159