A young girl with diabetes injects herself with insulin.
Twenty thousand U.K. children will be screened for type one diabetes in a landmark study that could lead to a national scheme.
The ELSA (EarLy Surveillance for Autoimmune diabetes) program will use blood tests to identify kids between 3 and 13 at risk of developing the lifelong disease.
Type one diabetes occurs when the body’s immune system attacks the pancreatic cells that produce insulin. Without this hormone, glucose cannot move from the bloodstream into the body’s cells, causing high blood sugar levels. Although it’s often considered a juvenile disease, it can occur at any age.
Most people are diagnosed once they develop a set of symptoms linked to prolonged high blood glucose: thirst, tiredness, weight loss and excessive urination. More than a quarter of children aren’t diagnosed until they reach diabetic ketoacidosis, a life-threatening condition caused by the toxic build up of ketones in the body.
But signs that the immune system is planning to attack the islet cells can be spotted far earlier, potentially reducing the risk of diagnosis in ketoacidosis.
The ELSA team will perform blood tests to identify certain “autoantibodies” linked to to type one diabetes. These markers are associated with a much higher change of developing the disease within the next fifteen years.
At-risk kids and their families will be given information on symptoms and education on the tools they may one day need to treat diabetes: insulin regimes and carbohydrate counting.
The study, funded by Diabetes UK and the JDRF, began recruiting children to the program on Monday.
The organisations hope not just that they will be able to better prepare kids at risk of diabetes, but that a screening program may one day be coupled with promising immunotherapies.
High-risk children in the ELSA program may be invited to join trials of treatments that may help delay the onset of diabetes itself. A drug called teplizumab, for example, can slow down diabetes diagnosis by up to three years.
Study leaders and University of Birmingham academics, Professor Parth Narendran and Dr Lauren Quinn, said: “As general population screening programmes for type one diabetes emerge around the world, we need to explore how best to screen children here in the UK. The ELSA study will ask important questions about the best ways to recruit, and explore the experiences of families who take part.”
Diabetes UK’s director of research Dr Elizabeth Robertson added: “We’re extremely proud to fund this pioneering research programme in partnership with JDRF. Identifying children at high risk of type one diabetes could put them and their families on the front foot, helping ensure a safe and soft landing into an eventual diagnosis, avoiding DKA and reducing the risk of life-altering complications.
“Every day without type 1 diabetes counts. Extra years without the condition means a childhood no longer lived on a knife-edge of blood sugar checks and insulin injections, free from the relentlessness and emotional burden of type one diabetes.”
