New test better predicts which babies will develop type 1 diabetes
A new approach to predicting which babies will develop type 1 diabetes moves a step closer to routine testing for newborns which could avoid life-threatening complications.
Scientists at seven international sites have followed 7,798 children at high risk of developing type 1 diabetes from birth, over nine years, in The Environmental Determinants of Diabetes in the Young (TEDDY) Study. The TEDDY Study is a large international study funded primarily by the US National Institutes of Health and U.S. Centers for Disease Control, as well as by the charity JDRF.
In research published in Nature Medicine, scientists at the University of Exeter and the Pacific Northwest Research Institute in Seattle used the TEDDY data to develop a method of combining multiple factors that could influence whether a child is likely to develop type 1 diabetes. The combined risk score approach incorporates genetics, clinical factors such as family history of diabetes, and their count of islet autoantibodies – biomarkers known to be implicated in type 1 diabetes.
The research team found that the new combined approach dramatically improved prediction of which children would develop type 1 diabetes, potentially allowing better diabetes risk counselling of families. Most importantly, the new approach doubled the efficiency of programmes to screen newborns to prevent the potentially deadly condition of ketoacidosis, a consequence of type 1 diabetes in which insulin deficiency causes the blood to become too acidic. Identifying which children are at highest risk will also benefit clinical trials on drugs that are showing promise in preventing the condition.
Dr Lauric Ferrat at the University of Exeter Medical School, said: “At the moment, 40 per cent of children who are diagnosed with type 1 diabetes have the severe complication of ketoacidosis. For the very young this is life-threatening, resulting in long intensive hospitalizations and in some cases even paralysis or death. Using our new combined approach to identify which babies will develop diabetes can prevent these tragedies, and ensure children are on the right treatment pathway earlier in life, meaning better health.”
Professor William Hagopian of the Pacific Northwest Research Institute, said: “We’re really excited by these findings. They suggest that the routine heel prick testing of babies done at birth, could go a long way towards preventing early sickness as well as predicting which children will get type 1 diabetes years later. We’re now putting this to the test in a trial in Washington State. We hope it will ultimately be used internationally to identify the condition as early as possible, and to power efforts to prevent the disease.”
Researchers believe the combined approach can also be rolled out to predict the onset of other diseases with a strong genetic component that are identifiable in childhood, such as celiac disease.
Sanjoy Dutta, JDRF Vice President of Research, said:” We know that while genetics have a strong correlation as a risk factor for family members to develop T1D, most newly diagnosed individuals do not have a known family history. JDRF has been exploring the non-genetic, environmental risk factors that trigger T1D to help develop treatments to forestall or prevent disease onset.”
The full title of the paper, co-led by Professor Richard Oram, Diabetes UK Harry Keen Fellow at the University of Exeter Medical School, is “A Combined Risk Score enhances prediction of Type 1 Diabetes Among Susceptible Children”
The Environmental Determinants of Diabetes in the Young (TEDDY) study is a longitudinal, multinational study examining genetic-environmental causes of type 1 diabetes (T1D). The study follows children at high genetic risk for T1D from birth to 15 years of age at 6 clinical centers in the U.S. and Europe. TEDDY is funded by the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), National Institute of Allergy and Infectious Diseases (NIAID), Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institute of Environmental Health Sciences (NIEHS), Centers for Disease Control and Prevention (CDC), and JDRF.
About the University of Exeter Medical School
The University of Exeter Medical School is part of the University of Exeter’s College of Medicine and Health. Our mission is to improve the health of the South West and beyond, through the development of high quality graduates and world-leading research that has international impact. As part of a Russell Group university, we combine this world-class research with very high levels of student satisfaction. Exeter has over 19,000 students and is ranked 12th in The Times and Sunday Times Good University Guide 2019. The University of Exeter Medical School’s Medicine course is in the top 10 in the Complete University Guide 2020, and The Times 2019 guide. The College’s Medical Imaging programme is ranked in the top 5 in the Guardian Guide 2020, the Complete University Guide 2020, and The Times 2019 guide. The University of Exeter entered the world top 20 for Biomedical and Health Sciences in the CWTS Leiden Ranking 2019, based on the percentage of publications ranked in the top 10 per cent most cited.
About the Pacific Northwest Research Institute
The Pacific Northwest Research Institute (PNRI) is the first non-profit biomedical research institute in Seattle, founded in 1956 by Dr. William Hutchinson. PNRI has a history of conducting cutting-edge biomedical research leading to advances that improve human health. Our current faculty of internationally recognized scientists is working to advance the understanding of the complex interplay of genetic and environmental factors that help maintain health or lead to the development of diseases, including diabetes.
JDRF’s mission is to accelerate life-changing breakthroughs to cure, prevent and treat type 1 diabetes (T1D) and its complications. To accomplish this, JDRF has invested more than $2.2 billion in research funding since our inception. We are an organization built on grassroots support of people connecting in their local communities, and then pooling resources on a national stage. We collaborate with academic institutions, policymakers, and corporate and industry partners to develop and deliver innovative therapies to people living with T1D. Our staff and volunteers throughout the United States and our six international affiliates are dedicated to the vision of a world without T1D. For more information, please visit jdrf.org or follow us on Twitter: @JDRF