A landmark study has paved the way for type 1 diabetes screening among children to stop them “crash landing” into diagnosis.
NHS pre-diabetes clinics for children are to be set up after the study confirmed the feasibility of using finger-prick blood tests to spot the disease before symptoms arise.
The study found children can be diagnosed in the earliest stage of type 1 (T1) diabetes, with experts saying the findings could lead to a “step change” in diagnosis and treatment.
Up to 400,000 people in the UK have T1 diabetes – which is around 8% of those with diabetes.
About a quarter of children with T1 are only diagnosed in an emergency situation. If children can be identified in the earliest stages, they can get access to treatments that can delay the need for insulin for years.
How was the study carried out?
The Early Surveillance for Autoimmune Diabetes (Elsa) study, led by the University of Birmingham and co-funded by Diabetes UK and Breakthrough T1D, was set up to assess the viability of screening in the UK.
The results from the first two years of the study have been published in correspondence published in The Lancet Diabetes and Endocrinology.
Children aged three to 13 without T1 diabetes were invited to participate. They provided a fingerprint blood sample checked for antibodies which have previously been found in pre-symptomatic patients.
Children identified as potentially at risk of T1 diabetes were invited for further blood tests or sugar tolerance tests.
Overall, 17,283 tests were analysed and more than 200 children were found to be at risk or have markers in their blood that indicate risk of T1D.
What happens next?
The next phase of the study, Elsa 2, will involve more children recruited, aged between two and 17.
This part of the study will support NHS clinics for four years at each of the UK’s 20 study sites. The clinics will help support and educate families where children are found to be at risk of, or have, early T1 diabetes.
Staff will also be able to help children as they start insulin treatment.
If approved by the NHS’s spending watchdog, some youngsters may have access to a new type of treatment, teplizumab – approved for UK use last year – which can help delay the need for insulin treatment.
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A new screening programme could, in the future, prevent children from “crash landing” into a diagnosis, said lead researcher Parth Narendran, professor of diabetes medicine at the University of Birmingham.
Treatments such as teplizumab, and others that are in the pipeline, could potentially be offered, he said.
Prof Narendran said this will mean they don’t need insulin therapy in the long-term, and they are kept in the “very early stage of T1 diabetes without insulin requirements”.
“It’s a massive step change,” he added.
