diabetes screening

New, more efficient screening developed for type 1 diabetes

by Barbara Hewitt on January 30, 2019

A new way of screening babies and adults for a future risk of type 1 diabetes has been developed by scientists who say it will be much more effective at identifying the condition than current methods.

Researchers at the University of Exeter in England and the Pacific Northwest Research Institute in Seattle have developed a risk score which takes into account detailed genetic information known to increase the chances of type 1 diabetes.

Doctor and Patient

(By Alexander Raths/Shutterstock.com)

They believe that this could be used to help identity babies at highest risk of developing the condition in the future. The score may also be used at the time of diabetes diagnosis to help decide if someone has type 1 or type 2 diabetes, which need very different treatments.

The team found that their new risk score, the T1DGRS2, which uses detailed analysis of key regions of the genome, was nearly twice as efficient at identifying babies at high risk of type 1 diabetes as existing methods, which use more simplistic measures.

The research, funded by charity Diabetes UK, also found that the new test was also better at predicting type 1 diabetes in adults in the general population.

‘Prediction of what diseases we might get in the future is an important area, and type 1 diabetes has a strong genetic element that we are now able to measure very well,’ said senior author Dr Richard Oram .

‘Measurement of the type 1 diabetes genetic risk score could help predict who will develop the condition from early life could help with research into potential early life interventions, and with classifying diabetes correctly at diagnosis,’ he added.

To develop the test, the team analysed genetic variation and gene interactions across the entire genome in 6,581 people with type 1 diabetes in the Type 1 Diabetes Genetics Consortium. They compared this to 9,247 control participants.

This helped them incorporate all known and recently-discovered genetic elements that can indicate type 1 diabetes. They then conducted simulations to see how their test compared to current genetic methods of diagnosis and screening.

Type 1 diabetes develops when the body’s own immune system attacks insulin-producing beta cells in the pancreas. The immune attack usually begins several years before the symptoms of type 1 diabetes appear.

Being able to identify who will develop type 1 diabetes before its onset could help parents and doctors identify the condition before it becomes severe, and help the development of effective treatments to prevent type 1 diabetes.

Current methods of early diagnosis involve measuring of islet autoantibodies, proteins in the blood indicating beta cell destruction. However, monitoring autoantibodies is expensive and difficult in young children.

The Exeter team recently discovered that half of all cases of type 1 diabetes develop in adulthood and can often be misdiagnosed. But the new risk score can help distinguish between type 1 and type 2 diabetes, helping healthcare professionals to make the right diagnosis.

‘Gathering all this genetic information together allows the test to perform better. This makes prediction of type 1 diabetes among all children much more affordable in public health settings. Parents can be warned to watch for early symptoms to avoid hospitalisation for life-threatening complications. Kids with the greatest future risk can get access to research trials to develop ways to delay or prevent progression to clinical diabetes,’ said co-author Dr William Hagopian.

According to Anna Morris, assistant director of research strategy and partnership at Diabetes UK, said it is exciting to see the power of genetics being harnessed to help predict who might develop type 1 diabetes in the future, particularly from a young age.

‘If successful, this approach could help to reduce someone’s risk of being misdiagnosed or developing complications during diagnosis. In the future, this research could also open up new insights into what could be done to stop type 1 diabetes from progressing,’ she pointed out.

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