By Drs. David Niesel and Norbert Herzog
Type I diabetes or juvenile diabetes is often diagnosed by measuring blood glucose levels during the life threatening acute onset of this disease,diabetic ketoacidosis. This often comes as a surprise to parents, requiring a trip to the hospital followed by rapid lifestyle adjustments and a serious increase in their healthcare expenses. A way to test for type 1 diabetes before the onset of symptoms would help prevent the dangerous consequences and give families time to be educated and prepared. Scientists in Germany have developed an easy and relatively inexpensive screening test that can be performed on infants that would predict the development of type 1 diabetes.
Most of the 29.1 million Americans with diabetes have what is called type II diabetes but about 1.25 million children and adults have type 1 diabetes. In 2010, diabetes was the seventh leading cause of death in the US. Both the incidence of diabetes and deaths from it are on the rise.
Scientists in Germany created the Fr1da study to screen for markers of type 1 diabetes in early childhood. Starting in 2015, they tested nearly 27,000 children to develop a fast, efficient and inexpensive screening test for type 1 diabetes. The test could be used on all children early on to identify those at risk of developing the acute onset of ketoacidosis. It would also reduce the psychological impact of the diagnosis through education and care could be used to assess the environmental exposures to identify possible triggers of type 1 diabetes.
Type 1 diabetes is an autoimmune disease that results in the destruction of beta cells in the pancreas which produce insulin. Current tests look for marker antibodies against our own proteins that are important in pancreatic cells. Today's tests require too much blood, are too expensive and labor intensive to be helpful for mass screening. So they developed a new cheap, fast test to identify the same antibodies requiring tiny amounts of blood generally taken from infants. Children usually develop these antibodies in the first few years of life with a peak incidence between 1-2 years old so their appearance would be predictive for type 1 diabetes.
Among the nearly 27,000 samples tested, 105 were found to be positive. About 80% of those initial tests were confirmed and so far 4 of those children developed type 1 diabetes. The children and their families were offered education and counseling. Among the children with positive tests, 89% were found to have normal blood glucose control, 9% had impaired glucose control that could lead to diabetes and 2% had type 1 diabetes. Only time will tell which additional children will develop type I diabetes. The good part is that these children will be closely monitored for the future onset of diabetes.
If the results of screening 100,000 children prove that this is an effective and low cost approach that predicts the development of type 1 diabetes, then it could prevent children from developing dangerously high glucose levels that lead to serious complications. It could then be broadly implemented and become part of the standard testing that keeps infants healthy.
Medical Discovery News is hosted by professors Norbert Herzog at Quinnipiac University, and David Niesel of the University of Texas Medical Branch. Learn more at www.medicaldiscoverynews.com.