Screening children aged between two and five helps to identify risk of type 1 diabetes before any symptoms have appeared, a pilot study has found.
Having been tested in an ongoing study in Germany, the Fr1da feasibility study found that identifying type 1 diabetes early also helps to reduce the risk of diabetic ketoacidosis (DKA), appearing prior to diagnosis. This is a dangerous short-term complication that can lead to coma or even death, and affects nearly one in three children newly diagnosed with type 1 diabetes.
The study, published in the BMJ Ope, investigated early diagnosis of the condition through the detection of pancreatic islet autoantibodies.
Efficient screening
Dr Anette-Gabriele Ziegler, author of the study from the Institute of Diabetes Research, Munich, said: “A screening test for early type 1 diabetes is feasible in this age group throughout the entire population.
“If efficient screening is implemented within a public-health prevention program, the majority of future cases of childhood clinical diabetes could be identified in infancy.”
The study aimed to evaluate whether the screenings can help to reduce emotional discomfort through advanced education and care. 26,760 children were screened over a period of nine months in 2015, with researchers hoping to test another 75,000 before the end of the year.
Islet autoantibodies were measured through capillary and venous blood samples, with 105 children testing positive for two or more.
Education and care
Those children were then invited to attend a half-day education programme with their parents at a local diabetes centre.
Children and parents were provided with information on how type 1 diabetes develops, blood glucose monitoring and the symptoms to look out for. This gives them preparation for type 1 diabetes developing and reduces the risk of serious problems developing, such as DKA. Parents were also provided with a direct care contact to assist them further.
Ziegler hopes the study could have a positive impact for screening for pre-type 1 diabetes across the world. She added: “Education of pre-type 1 diabetes is a novel concept that has not been previously explored.
“With the Fr1da study we want to set new standards in the diagnosis and treatment of type 1 diabetes by a diagnosis in the early, asymptomatic stage and the provision of comprehensive medical and psychological care for the affected families.”

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