Information about type 1 diabetes: Type 1 diabetes is a lifelong and serious condition. It occurs when the immune system makes a mistake and destroys the cells in the pancreas which make insulin. These are called beta cells. Diagnosis usually occurs when about 80% of beta cells have been destroyed. The immune system can act very quickly to destroy these cells in some people but much more slowly in others.
Until recently most studies of autoimmune diabetes studied relatives of children with type 1 diabetes but more than 90% of type 1 diabetes occurs in members of the general population where no-one else in the family has a diagnosis – people in the general population.
Research from studies of type 1 diabetes in children: Until now, most studies of type 1 diabetes have been in children so much is known about when the insulin producing cells are destroyed by the immune system. This process can start from about the age of 6 months. Proteins in the blood called islet autoantibodies appear. There are four main types; autoantibodies to insulin, GAD, IA-2 and ZnT8. If a child under 5 years has more than one of these autoantibodies, they are at more than 80% risk of developing diabetes by the age of 20.
Information about type 1 diabetes in adults: more than half of type 1 diabetes is diagnosed in adults but it is still often considered a condition that initiates in children. There are some people who develop islet autoantibodies in childhood but do not develop symptoms – so called “slow progressors”. However we do not think that all who develop autoimmune type 1 diabetes in adulthood slowly progress to developing symptoms. We do know that unlike in children, autoantibodies to GAD are the most common but we do not know why. In addition, we have developed a new test for autoantibodies to GAD which is better at predicting type 1 diabetes. T1DRA is the first study to test adults in the general population for risk of type 1 diabetes.
What happens after T1DRA
We predict that approximately 0.5-0.7%% of adults in the general population will have two or more islet autoantibodies and be “at risk” of developing type 1 diabetes in the future. These individuals can be followed up yearly in T1DRA using simple tests which can be sampled at home.
Participants who are found to have markers of increased risk (by testing their blood) participants will be made aware of the “At Risk of Autoimmune Diabetes” (ARAD) study (arad-study@bristol.ac.uk) with more detailed follow up. This will involve volunteers giving a venous blood sample for research tests.
Participants in both T1DRA and ARAD will be made aware of the opportunity to test new treatments that could delay the start of type 1 diabetes.
Thank you to our funders and all who have helped to develop this study.