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Trial to screen children for type 1 diabetes now available in Northern Ireland

Children in Northern Ireland are now eligible for a trial screening programme that will identify those at high risk of developing type 1 diabetes in the future.
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Breakthrough T1D staff 16 October 2023

ELSA testing kits to screen for type 1 diabetes in children

Children in Northern Ireland are now eligible for a trial screening programme that will identify those at high risk of developing type 1 diabetes in the future.

Launched in England, Scotland and Wales in November 2022, the trial is the first of its kind for the UK which will lay the groundwork for the development of a potential future UK-wide screening programme, transforming how type 1 diabetes is identified and managed in its earliest stages.

Funded by JDRF together with Diabetes UK, ELSA (EarLy Surveillance for Autoimmune diabetes) aims to recruit 20,000 children, aged 3-13 years, to assess their risk of developing type 1 diabetes through at-home finger-prick blood tests. Home testing kits are now available to families throughout Northern Ireland. Around 1 in 100 children will require follow-up venous blood testing, available at the Southern Health and Social Care Trust.

What does the screening look for?

The ELSA research team are able to identify people at high risk of type 1 diabetes by testing for markers in the blood, called autoantibodies – tools used by the immune system to earmark insulin-producing cells for destruction. Autoantibodies are associated with the development of type 1 diabetes, and can appear in the blood years, or sometimes decades, before people begin to experience any symptoms.

Risk of type 1 diabetes increases with the number of different autoantibodies present in the blood. Children with two or more autoantibodies have an 85% chance of developing type 1 diabetes within 15 years, and it is almost certain that they will develop the condition in their lifetime.

What support are children at risk of type 1 given?

Children found to be at risk and their families will be offered support and education – including information on symptoms and management – to help prepare them for the diagnosis of type 1 diabetes.

Families will also be offered the opportunity to be followed up in the long-term to enable closer monitoring and potentially to start insulin treatment sooner. Research in Europe and the US has found that the extra support and monitoring screening programmes can offer, dramatically reduces the risk of being diagnosed in diabetic ketoacidosis (DKA) – a life-threatening condition.

Are there any preventative treatments?

While type 1 diabetes is currently managed using insulin, there are new immunotherapy treatments on the horizon that could prevent or delay the condition. Children found to be at high risk through ELSA could be invited to take part in research testing these treatments. One such treatment, teplizumab, which has been found to delay a diagnosis of type 1 diabetes by up to three years, was approved in the U.S. last year and is currently under review in the UK.

Preventative treatments for type 1 diabetes can only be effective when combined with screening programmes to identify those at risk. By offering vital insights that could make routine, widespread screening for type 1 diabetes a reality in the UK, ELSA could be critical to help unleash the benefits of teplizumab if approved here.

What impact can screening have on families?

Edelle Irwin, whose six-year-old son is taking part in ELSA, said: “When my son Shane was rushed to hospital and diagnosed with type 1 diabetes, we had no idea what to expect. Seeing my seven-year-old hooked up to all those machines, surrounded by nursing staff in a hospital bed will be forever etched in our minds. If we had recognised the symptoms earlier, that day would not have turned into the emergency situation it was.

“Now that ELSA is available in Northern Ireland, I’m relieved to be getting my youngest son screened for type 1. He also has autism and screening would allow us to plan in the case of a diabetes diagnosis and management, given the extra challenges his sensory issues may cause. I would urge other families in Northern Ireland to get their children screened too so that they have the tools to keep their children safe and possibly avoid a similar situation to us.”

What do the researchers say?

Parth Narendran, Professor of Diabetes Medicine, and Dr Lauren Quinn, Clinical Research Fellow at the University of Birmingham, said: “The ELSA team are delighted to open the ELSA study in Northern Ireland. Over 9,000 children from across England, Scotland and Wales are already part of the study. ELSA aims to screen 20,000 children to find out their risk of type 1 diabetes. Screening and monitoring help prevent emergency presentations with type 1 diabetes. Families identified at risk are offered education and participation in monitoring programmes, the opportunity to participate in clinical trials and potentially also therapies to delay the onset of type 1 diabetes if these are licensed in the UK.”

Rachel Connor, Director of Research Partnerships at JDRF UK, said: “We are delighted that the ELSA study is expanding to Northern Ireland, building on the incredible success of the screening programme in the rest of the UK. The dedicated research team will ensure children in Northern Ireland at risk of type 1 and their families are supported and monitored to give them the best possible start in their journey with the condition.

“At JDRF, we believe it is vital that everyone in the UK has access to the latest advances in type 1 diabetes research. This important move by the ELSA study paves the way for children in Northern Ireland to be included in the testing and roll out of future immunotherapies to slow the progression of type 1, such as teplizumab.”

Where can I find out more about ELSA and sign up?

For further information on ELSA, please visit elsadiabetes.nhs.uk

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