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Population-based screening for type 1 diabetes risk could prevent ketoacidosis and slow progression of disease

General population screening could prevent diabetic ketoacidosis and slow the development of type 1 diabetes in children, according to a new opinion paper.
The paper, written by JDRF Chief Scientific Officer Richard Insel and colleagues, suggests that projects that screen relatives of people with type 1, while helpful, are not as effective as they could be; only around 15 per cent of people with type 1 diabetes have diabetic relatives.
Instead, the paper outlines, children need to be screened for pre-symptomatic type 1 diabetes. This would not only make it easier for type 1 diabetes to be detected before the onset of diabetic ketoacidosis – a severe complication that can lead to coma and even death – but would also support clinical trials that are working towards slowing the progression of type 1 diabetes.
January saw the launch of the FR1da Diabetes Model Project, which screens children in Germany for islet autoantibodies linked to the development of type 1 diabetes. If the children have more than one such autoantibody, they are considered at a high risk of type 1 diabetes. These children are invited to take part in an intervention trial, which is designed to stop the type 1 diabetes progressing fully.
Similar projects have already had some degree of success. The Environmental Determinants of Diabetes in the Young study, which follows children who have relatives with type 1 diabetes, found that screening babies for particular antibodies led to lower rates of diabetic ketoacidosis among children who were later diagnosed with type 1 diabetes.
Ultimately, the development of better screening programmes could lead to improved therapies that prevent type 1 diabetes from fully progressing.

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