Did you know that Australia has three existing national screening programs for bowel cancer, breast cancer and cervical cancer? Incredibly, bowel cancer screening alone will prevent an estimated 59,000 deaths by 20401, if current participation rates continue.
A similar program for type 1 diabetes (T1D) could have a huge impact on how the condition is diagnosed, managed, and even prevented in the future – and JDRF Australia is at the forefront of making this vision a reality.
Decades of T1D research mean that already, we can reliably identify people with early-stage T1D through simple screening methods.
So, how does it all work? And what does T1D screening look like in Australia right now? Let’s delve into this promising frontier of T1D research and explore why it matters so much.
What is T1D screening?
T1D is an autoimmune condition where the immune system mistakenly attacks the body’s own insulin-producing beta cells in the pancreas, leading to their loss and an inability to produce insulin.
Currently, most diagnoses take place once symptoms have begun. Common signs are the '4T symptoms' of excessive thirst, fatigue (tired), weight loss (thin) and frequent urination (toilet). However, decades of research have shown that T1D begins well before these symptoms develop and a diagnosis is made.
A hallmark of the early stages of the condition is the presence of 'autoantibodies', markers that can be easily detected in the blood and are a sign that the immune system has already begun attacking the beta cell of the pancreas. Screening for T1D involves detecting these autoantibodies in a blood spot or traditional blood sample.
You can read more about the stages of T1D here.
It’s believed that an environmental event triggers immune attacks in people who are genetically susceptible. A marker of this autoimmunity is the production of autoantibodies, which can be detected in the blood.
Screening via blood spot testing or saliva samples can detect these autoantibodies.
Why is it so important to screen for T1D?
Many people are surprised to learn that 90% of people diagnosed with T1D have no family history of the condition and therefore would not normally be screened.
Screening for early stage T1D can identify very early signs of the condition before any symptoms have developed. This is important as even when T1D reaches the symptomatic stage, it can be missed, as the 4T symptoms can be mistaken for something else.
That’s why currently, one in three childhood T1D diagnoses occur only after emergency hospitalisation with a critically dangerous condition called diabetic ketoacidosis (DKA). Not only is this a traumatic experience for the child and their family, but DKA on diagnosis is associated with worse long-term health outcomes.
The current (& future) benefits of T1D screening
> Reducing the trauma of shock diagnosis
Screening means that parents would have advance warning if their developing T1D, giving them time to prepare for a diagnosis.
> Lowering the incidence of DKA and improving long term quality of life
Children diagnosed with T1D at an early stage and who have medical follow-up have a much lower risk of experiencing DKA upon a traditional diagnosis. DKA causes significant stress for families, and research shows that people who experience severe DKA have worse long term health outcomes. Preventing DKA may lead to better outcomes for people living with T1D and reduce stress for them and their families.
> Unlocking opportunities for new treatments to delay or intercept the development of T1D
Some of the new medications, known as disease, are being tested in early stage T1D. Identifying people in these early stages is therefore critical to allowing them access to clinical trials testing these new drugs which have the potential for delaying or preventing symptomatic T1D. Additionally, people in the early stages of T1D could access DMTs like Teplizumab, which was approved for T1D in the US 2, to delay symptomatic T1D as they become available in Australia.
JDRF funds the Type 1 Diabetes National Screening Pilot
JDRF Australia is funding the Type 1 Diabetes National Screening Pilot, a project comparing simple methods of T1D screening in newborns and older children, with the goal of making routine childhood T1D screening available for every child in Australia, not just those with a family history of the condition.
Before a National Screening Program can be implemented, decision makers must ensure the best screening method is used and that it is cost-effective. That’s why researchers undertake pilot studies – where screening is offered to a small group of people to see whether the idea is ready to be expanded to the whole population.
In the Pilot, a total of 9,000 children across Australia are taking part in T1D screening through three different methods. Excitingly, recruitment has now finished, and the Pilot is well underway across the country.
The data gathered from the Pilot may inform government policy so that we can bring a national T1D screening program to Australia.
To learn about screening available to those who do have a family history of T1D, click here.
How you can help
Your support can make a world of difference. By contributing to initiatives like Giving Day on 30 May, you amplify the impact of T1D screening projects, bringing us closer to a future where T1D is not just managed but prevented.
Donate to Giving Day and double your impact here.
Sources
- Jie Bin Lew, St JB, Xiang Ming Xu, et al. Long-term evaluation of benefits, harms, and cost-effectiveness of the National Bowel Cancer Screening Program in Australia: a modelling study. The Lancet Public health. 2017;2(7):e331-e340. doi:https://doi.org/10.1016/s2468-2667(17)30105-6
Double your impact now!
Australia is at a turning point for type 1 diabetes (T1D) research. With new treatment options on the horizon and screening initiatives scaling faster than ever before, there’s never been a more exciting time to support local breakthroughs.
When you donate now, your investment in a world without T1D doubles – helping make the next big T1D breakthroughs a reality.
