Improving screening tests for type 1 diabetes

Why is JDRF funding this research?

Screening the UK population for type 1 diabetes is vital for detecting the condition early and reducing the number of people diagnosed in crisis in diabetic ketoacidosis. We are funding a screening programme in the UK called The ELSA Study, in which researchers are testing 20,000 children in the UK for type 1 diabetes. Improving the screening test used in the ELSA Study will increase its chances of success and help accelerate the UK towards a routine national screening programme for type 1.

What screening test for type 1 is ELSA using?

Currently, the ELSA study involves three rounds of blood tests to pin-point which markers of type 1 (known as antibodies) are present in each child’s blood. Each test is sent to a lab to be processed, leaving families with an anxious wait for results.

A new type 1 diabetes screening test

To streamline the screening process, Alex will develop a lateral flow test for type 1, similar to the ones commonly used to test for COVID. The test will show all four different antibodies that are markers of type 1 diabetes risk.

Quick, easy and convenient screening

Once Alex finishes developing her screening test, families can use it at home at their convenience to get immediate results on their risk of type 1. This will give instant reassurance to the 99% of individuals who will receive a negative result. The home test kits will also allow DNA collection which can be posted back to the laboratories to check a person’s genetic risk of type 1.

Why test for both antibodies and genes?

There are advantages and disadvantages to both genetic and antibody tests, so testing for both covers more bases. The antibody tests show whether someone is currently in the early stages of developing type 1, but they are a snapshot in time. Whereas the genes we have don’t change. If you have certain genes, you are more likely to develop type 1, but you may never actually develop it. By combining the results of both tests, healthcare professionals can make a more informed judgement about a person’s risk of developing type 1.

How will Alex’s project help people with type 1?

An effective screening test is key to an effective screening programme for type 1 diabetes, which could completely change how we manage type 1 globally.

In the short-term, Alex’s faster, more convenient screening test will encourage more families to get their children screened for type 1. Her test will allow screening programmes to run more efficiently and be more successful. This will hopefully lead to lower numbers of children being diagnosed in the dangerous state of diabetic ketoacidosis due to the increased awareness and education that screening brings.

Screening helps prevention and treatment research

The longer-term benefit of an effective screening programme will be offering prevention studies to children in the earliest stages of type 1 diabetes. Some medicines (like teplizumab) can safely delay children getting type 1 diabetes by over three years. With teplizumab now approved for use in the US, it is more important than ever to establish a population screening programme in the UK so that we are ready when the drug is approved here.

Is JDRF funding any other research like this?

We are funding the ELSA Study, which is the screening project for type 1 diabetes that Alex is developing her improved antibody test for. By funding both projects, we are ensuring the screening study achieves the best possible results.

We also fund Professor Richard Oram’s work to develop a risk score calculator for type 1. Healthcare professionals can input a patient’s age, genes and antibodies to determine their risk of developing type 1 in the next year, three years and five years.