Key to preventing type 1 diabetes is knowing who will go on to develop the condition. Our Research Communications Manager, Conor McKeever, explains how screening for type 1 diabetes is bringing us one step closer to this goal.
At JDRF, we’re committed to eradicating type 1 diabetes and its effects. For people who already have the condition, that means finding a cure, and making life easier until one is found.
But to truly create a world without type 1, we need to be able to prevent anyone else from ever developing it.
That means knowing who will go on to develop type 1, before they even have the symptoms.
That’s an immense challenge.
For many conditions, there are screening programmes in place that can identify who is at risk. These enable clinicians to monitor those people more closely – and, if appropriate, to intervene with a preventative treatment.
But, currently, no widespread screening programme like this exists for type 1 diabetes. The JDRF-supported TrialNet study enables relatives of people with type 1 to test for their risk of developing the condition, but most people who have type 1 have no known family history of the condition.
Widespread screening for type 1 diabetes
What’s needed is universal screening for type 1 diabetes, that could be rolled out by health services across the world.
The JDRF-funded Fr1da study, led by Professor Anette-Gabriele Ziegler, is testing one such system. What’s more, her research has already shown the benefits that a screening programme could bring.
By screening more than 90,000 pre-school children across Bavaria, Germany, Fr1da was able to slash rates of diabetic ketoacidosis (DKA). DKA is a complication of type 1 that occurs when the body has a severe lack of insulin.
In the UK, around 25 per cent of children with type 1 are diagnosed so late that they’re hospitalised with DKA. In the US, the proportion of children who have DKA at diagnosis is more than 40 per cent.
Thanks to screening, the Fr1da study managed to bring this number down to just five per cent. That’s because the children who were at risk could be monitored more closely, and diagnosed more promptly.
Pathway to prevention
The benefits don’t stop there.
If we know who is at high risk of developing type 1, it would be easier to enrol them in clinical trials aimed at halting or delaying their progression towards type 1.
Last year, a JDRF-supported clinical trial showed that an immunotherapy called teplizumab was able to do just that. It delayed the onset of type 1 by an average of two years in people at high risk of the condition.
That’s two years without fingerprick testing, carb counting, or worrying about hypos and hypers.
The trial was run through TrialNet, but a widespread screening programme would give more people the opportunity to take part in research like this.
What’s more, it would give our scientists an even better understanding of what happens in the run-up to a diagnosis of type 1. This could enable them to accelerate their research into preventing the condition, and to discover more game-changing drugs like teplizumab.
Looking to the future
So, what’s next for screening for type 1?
Now that Fr1da has shown that a large-scale screening programme is possible, Professor Ziegler will now expand its reach. They are already extending screening tests to children aged 9-10 years.
The researchers will also perform a cost-benefit analysis of the screening programme. This would be vital evidence for making screening for type 1 diabetes a routine part of healthcare systems.
And at JDRF, we’ll be working with Professor Ziegler to understand how best to design screening programmes for clinical trials and, potentially, for routine healthcare.
These extraordinary times are new to us all but we will not stop in our efforts to cure type 1. Together with your support, we deliver life-changing breakthroughs for people with this condition. If you can, please consider making a gift today to help find better treatments and a cure for type 1 diabetes.