Normally, our immune system ignores our body’s own safe cells and attacks only dangerous foreign cells. But our bodies create autoantibodies—antibodies against our own proteins—when, for some reason, our immune system doesn’t discriminate between the safe and dangerous cells.
Most children with more than one type of autoantibody goes on to develop type 1 diabetes (T1D)—approximately 50 percent within five years and 80 percent within ten. Jessica Dunne, Ph.D., director of the prevention research program at Breakthrough T1D, says almost everyone is eventually affected. “We know for sure that once an individual has two or more autoantibodies, of any combination, their lifetime risk of T1D approaches 100 percent.” That’s why although nobody knows when a specific person will develop clinical symptoms, it is imperative to discuss screening for larger portions of the world’s population, especially because cases of T1D rise 3 to 4 percent per year.
The biggest problem with these autoantibodies is that they are asymptomatic. That means they show no symptoms. Without early detection, a person won’t know that they are at an increased risk of developing T1D. Fortunately, there are a few key advantages to screening all children for T1D.
First, early detection helps prevent diabetic ketoacidosis (DKA). DKA happens when a person doesn’t produce enough insulin to help the body use sugar circulating throughout its blood. Since there is no energy gained from carbohydrates, the body turns to burning fats for fuel instead, and it becomes life-threatening if not caught early. Therefore, a person that knows they have multiple autoantibodies is aware of the associated risk. They have the information necessary to avoid this event, which even when not deadly can lead to poor long-term glucose control. DKA is currently an indicator of T1D for 20 to 50 percent of new T1D cases.
Secondly, screening for autoantibodies can also reduce the length of hospital stays at the onset of the disease, improves future metabolic control and lowers the stress level and burdens on a loved one’s family. In the future, this opportunity may help delay insulin-dependence or prevent it altogether.
Finally, early detection may help extend the lifespans of those with T1D.
Fortunately, there are a few places where such early detection efforts are being tested. The Fr1da study, administered by Helmholtz Zentrum München, the German Research Center for Environmental Health, screens children aged 2-5 for autoantibodies during regular checkups. More than 90 percent of clinicians there in Bavaria, Germany, approve of the measure, which has screened over 90,000 children to date. After Fr1da began, other communities have set up similar studies. Fr1dolin is located in Lower Saxony, Germany, and Autoimmunity Screening for Kids (ASK) is located in Colorado in the United States.
Click here to learn more about how Breakthrough T1D is funding ways to help prevent T1D. Or watch these clips to hear:
A call to action to pick up T1D before the stage of symptoms
The long-term benefits of screening and the societal cost-savings
The screening benefit for A1c number
The multiple benefits of screening, including reduced complications
