Young children can undergo a routine fingerprint blood test to determine their risk of developing type 1 diabetes – and receive medication to slow the disease.
The problem, which affects one in 500 children in the UK, occurs when the immune system mistakenly attacks cells in the pancreas and stops producing the hormone insulin, which keeps blood sugar levels stable.
Patients must inject insulin regularly to stay alive and prevent diabetic ketoacidosis, or DKA, a life-threatening condition in which the blood becomes toxic.
About a quarter of children with type 1 are only diagnosed after being hospitalized with DKA. But identifying children at risk of diabetes as young as two through a blood test – before they show dangerous symptoms – enables the use of new drugs such as the immunotherapy teplizumab. It protects the cells in the pancreas and slows down the development of the disease. It can also prevent hundreds of DKA episodes per year.
The problem, which affects one in 500 children in the UK, occurs when the immune system mistakenly attacks cells in the pancreas and stops producing the hormone insulin, which keeps blood sugar levels stable.
Diagnosing type 1 diabetes at an earlier stage makes it easier to treat the disease
Experts say this delay can reduce the risk of serious complications of type 1 diabetes, such as limb amputations, heart and kidney disease, and blindness, and make the disease more manageable in the long term.
Professor Parth Narendran, a type 1 diabetes specialist from the University of Birmingham, is leading a study that will recruit 20,000 children to evaluate the screening method. He said: “There is already evidence from other European studies that screening can reduce DKA rates and improve blood sugar control and mental health.” This will save the NHS money.
“It is very important that there are medicines currently in development that can delay the onset of diabetes.” Hopefully, there will be long-term relief through the use of sequential therapies. The later a person develops the disease, the easier it can be to deal with it. And the less damage done in childhood, the better results can generally be achieved.”
The fingerprint test looks for malignant immune proteins called autoantibodies that attack the insulin-producing cells of the pancreas.
Professor Colin Dayan of Cardiff University told the European Association for the Study of Diabetes (EASD) conference that children with “two or three” different types of autoantibodies are more than 90 per cent more likely to develop the type within 15 years – Get 1 diabetes. .
The British screening test, called ELSA, only examines a spot of blood on a child’s finger – similar to the routine heel test for newborns, which looks for nine life-limiting conditions.
Children who test positive for various autoantibodies then undergo further testing to determine if they are at risk for the disease.
These harmful proteins develop over time and are therefore not currently tested as part of the heel prick test in newborns. But that could change.
“We can do a genetic test as part of the newborn program to find those at highest risk and then offer them the antibody test when they are two or three years old,” says Prof Narendran.
Before the Covid-19 pandemic, the incidence of type 1 diabetes in children increased by approximately three percent per year. This rose significantly to 14 percent in the first year of the pandemic (2020), followed by a further 27 percent in 2021.
The increase suggests that infection with Covid-19 may trigger the development of type 1 diabetes, although this is not yet fully understood.
Five years ago, epidemiologists predicted that there would be 33,100 children and young people (aged 0-19) with type 1 diabetes in the UK by 2023, and the number is expected to rise to 33,800 by 2029. More than 35,000 cases are expected this year, and experts now expect many more people to have the disease than expected by the end of the decade.
Dr. Emily Sims, associate professor of paediatrics at the Indiana University School of Medicine in the US, said at the EASD conference: “Our understanding of type 1 diabetes has now evolved from the idea that it is a disease that develops suddenly, develops in the scientific knowledge that it is something that occurs suddenly.” develops gradually after the appearance of various autoantibodies.
“By screening children and adults to identify people with early, pre-symptomatic stages of the disease, we can more accurately predict when they first need insulin and prevent life-threatening DKA episodes.”
It is understood that there is an “ongoing dialogue” with the government’s National Screening Committee about the possibility of screening for type 1 diabetes.
A spokesman for type 1 diabetes charity JDRF, which funds ELSA with the charity Diabetes UK, said: “We hope this trial will provide the government with the evidence it needs to introduce screening for children. “
The ELSA study is recruiting children aged three to 13 for screening, but Prof Narendran says younger children may be able to participate.
He adds: “The German study looked at children between the ages of two and five.” We started at age three just to give the kids another year for the autoantibodies to develop. But many families are asking if we can start testing younger children, so we will try to reduce the number to two.”
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Crystal Leahy is an author and health journalist who writes for The Fashion Vibes. With a background in health and wellness, Crystal has a passion for helping people live their best lives through healthy habits and lifestyles.
