Australia could become the first country to adopt routine screening for type 1 diabetes in children

If the pilot is successful, Australia could become the first country to adopt routine child screening to detect type 1 diabetes in children.

Type 1 diabetes (T1D) is a lifelong autoimmune disease that occurs when the immune system mistakenly attacks insulin-producing cells in the pancreas. It is frequently diagnosed in children and adolescents, with three Australian children diagnosed each day.

The current diagnosis of T1D comes too late, with 1 in 3 Australian children going undiagnosed before needing emergency care, as early signs and symptoms of T1D, such as fatigue and excessive thirst, can easily be missed or confused with other minor childhood problems.

Ninety percent of those diagnosed have no family history of T1D, which means that routine child screening is the only way to identify most children at risk.

Screening for T1D has been shown to allow for earlier diagnosis, before a child shows clinical signs of the disease or develops diabetic ketoacidosis (DKA), a life-threatening complication of diabetes that requires admission to care. intensive.

Dr Kirstine Bell of the University of Sydney, principal investigator leading the program, says the National Type 1 Diabetes Screening Pilot Project being launched will help determine the best way to implement screening in Australia, while identifying people with type 1 diabetes at an early stage.

“The pilot program will be rolled out in five states over the next few months, to compare different screening methods, including dried blood tests in newborns and older children and saliva samples in infants. Each method is simple, safe, effective and will be provided free of charge to families at the pilot sites,” said Dr Bell of the University’s Charles Perkins Center.

“The results will give us the evidence base to determine the most appropriate adoption model in Australia and provide participating families with the benefits of early detection, which can help prevent serious illness and DKA at the time. diagnosis, improve long-term disease outcomes. and providing access to the right resources and support at the right time.

This type of screening is only possible because of a new T1D staging classification that identifies two early and presymptomatic stages (stages 1 and 2) of T1D that mark the onset of the disease rather than the previously late diagnosis and symptomatic (stage 3), when the insulin-producing cells of the pancreas have already been destroyed.8 Stages 1 and 2 of T1D can be present for months or years before symptoms appear and can be detected by simple screening.

Most children who are screened will receive a normal test result. For those identified with early-stage type 1 diabetes, they will likely still feel perfectly fine without symptoms and will be referred to a childhood diabetes specialist for ongoing care and monitoring.

This detection and referral to a specialist is important for families, as studies show that for those diagnosed at stages 1-2, the vast majority will progress to symptomatic, insulin-dependent T1D before adulthood.

The pilot program is funded by JDRF, the leading non-governmental funder of T1D research worldwide.

JDRF Scientific Director Dr. Dorota Pawlak says early detection is an essential step in the T1D journey and opens avenues to intercept the condition further down the track.

“The National Type 1 Diabetes Screening Pilot Project is a very exciting advance for T1D research that could enable early detection on a population scale and offer opportunities for preventive interventions.

“While there is no cure for type 1 diabetes yet, alongside early detection projects, JDRF is also investing in a number of research projects that investigate how to delay or prevent the onset of symptomatic T1D. during the early stages of the disease.

“Rolling out screening would mean that participants identified as having early-stage type 1 diabetes could be offered to enroll in clinical trials for preventative treatments, which, if successful, could become more widely available. for anyone who needs it.”

The National Type 1 Diabetes Screening Pilot Project aims to make early detection of type 1 diabetes available to every child in Australia.

If this type of screening were adopted in the Australian healthcare system, the trajectory of T1D care could be transformed and put Australia in a good position to become the international leader in T1D care.