Medics hope a new screening programme set to involve 20,000 children could transform how Type 1 Diabetes is detected.
Launched on World Diabetes Day - November 14 - the scheme will identify children at high risk of the condition. The aim is to recruit 20,000 children aged between three and 13 for the programme - which is called ELSA. That stands for "Early Surveillance of Autoimmune diabetes".
Up to 400,000 people in the UK have Type 1 diabetes - which is the most common form of diabetes found in children, and not linked to lifestyle factors. In the main, those affected are unable to produce their own insulin. By comparison, Type 2 Diabetes tends to affect older people and sees them often develop either insulin resistance or not produce enough insulin to deal with high blood sugar levels.
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The new trial - funded by Diabetes UK and the JDRF - will look into practical and effective ways to go about screening large numbers of children. Those found to be at high risk of diabetes could be channelled towards clinical trials like the Impact study currently ongoing at the Newcastle Diabetes Centre.
That trial is seeking to find ways to treat early-stage diabetes before someone has necessarily stopped producing their own insulin - so the more that children are diagnosed earlier, the more likely treatments like this could help. At the moment, over a quarter of children are not diagnosed with Type 1 diabetes until they are in a potentially fatal condition called diabetic ketoacidosis.
Now, the new project will assess children’s risk of Type 1 diabetes through a combination of finger prick and intravenous blood tests. Medics led by the University of Birmingham will look for autoantibodies - which the immune system uses to destroy insulin producing cells in some diabetics. These can appear in the blood years before people begin to experience any symptoms.
Parth Narendran, Professor of Diabetes Medicine, and Dr Lauren Quinn, Clinical Research Fellow at the University of Birmingham, said "As general population screening programmes for Type 1 diabetes emerge around the world, we need to explore how best to screen children here in the UK. The ELSA study will ask important questions about the best ways to recruit, and will explore the experiences of families who take part.
"Screening children can reduce their risk of DKA at diagnosis around five-fold and can help them and their families settle into the Type 1 diagnosis better. We know the value of identifying people at risk of Type 1 diabetes and we have the tools to do so – now we need to understand how best to implement them in the UK."
St Helen's couple Jayne and Mike Fairclough whose daughter Libby was diagnosed with diabetes at the age of three, said early diagnosis would make a huge difference. Jayne said: "When Libby was diagnosed with type 1 diabetes, our world was turned upside down. Looking back all the signs were there, but we knew nothing about diabetes and never thought it would be that. We weren’t prepared for what was to come – diabetes took over our lives."
She said that screening could "help families avoid the shock diagnosis that we went through" and added the family would definitely want to know if younger daughter Lottie, two, was at risk too.
Diabetes UK director of research Dr Elizabeth Robertson said: “Every day without type 1 diabetes counts. Extra years without the condition means a childhood no longer lived on a knife-edge of blood sugar checks and insulin injections, free from the relentlessness and emotional burden of type 1 diabetes."
Immunotherapy treatments are currently being reviewed in the UK and US - and Dr Robertson said this meant "the era of being able to strike early to delay Type 1 diabetes is within reach".
Find out how your child can take part in the ELSA study and sign up at elsadiabetes.nhs.uk/take-part
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