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A straightforward finger-prick blood test could become a routine screening tool offered to all children across the UK to detect type 1 diabetes at an early stage, according to researchers involved in a comprehensive study. Many young people currently receive their diagnosis only after severe complications develop, such as diabetic ketoacidosis, a dangerous condition that requires emergency hospital care. Early identification of the disease would allow for timely interventions to manage blood sugar levels effectively and reduce the risk of these critical situations.
The Early Surveillance for Autoimmune Diabetes (ELSA) study, supported by diabetes charities, has already screened approximately 17,000 children between the ages of three and 13. This initiative has uncovered children like 12-year-old Imogen from the West Midlands, who was diagnosed through the program. Imogen’s mother, Amy, emphasizes how having advance knowledge helped them prepare better, providing reassurance that they were not caught off guard by the diagnosis. Amy, who herself has lived with type 1 diabetes since age 13 after a crisis caused by diabetic ketoacidosis, appreciates the difference this early detection makes. Imogen is currently undergoing immunotherapy with a drug called teplizumab, which aims to delay the progression of type 1 diabetes by calming the immune system’s attack on the pancreas. Although this treatment is not yet widely available in the NHS, Imogen is one of the few children in the UK to receive it.
The screening test used in ELSA identifies autoantibodies in the blood—proteins produced by the immune system that mistakenly target the pancreas. This organ is responsible for producing insulin, the hormone critical for blood sugar regulation. A family history of type 1 diabetes is known to elevate risk, and researchers suggest that environmental factors such as viral infections may also trigger the autoimmune process. Preliminary results from the study, published in *The Lancet Diabetes & Endocrinology* and funded by Diabetes UK and Breakthrough T1D, revealed that out of the 17,283 children tested, 75 had one autoantibody indicating increased risk; 160 children had two or more autoantibodies consistent with early-stage disease but did not yet need insulin; and seven were newly diagnosed with type 1 diabetes and required immediate insulin treatment. Children without these autoantibodies are highly unlikely to develop the disease.
Diabetes UK’s Dr. Elizabeth Robertson highlighted the potential benefits of early detection, stating, “For too many families, a child’s type 1 diabetes diagnosis still comes as a frightening emergency. But that doesn’t have to be the case. Thanks to scientific breakthroughs, we now have the tools to identify children in the very earliest stages of type 1 diabetes—giving families precious time to prepare, avoid emergency hospital admissions, and access treatments that can delay the need for insulin for years.” Rachel Connor from Breakthrough T1D also expressed optimism about the impact of the findings, seeing them as a significant step towards earlier diagnosis, better management, and the possibility of delaying the disease through immunotherapy. Building on this progress, the next phase of the study, ELSA 2, plans to expand screening to include children aged 2 to 17 years, with the finger-prick test being accessible at home, school, or GP clinics. Several other countries, like Italy, are already implementing childhood diabetes screening, and the decision for similar measures in the UK will rest with government officials and advisory bodies such as the National Screening Committee
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