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DUKPC Digest Day 4: AI helps spot type 1 diabetes earlier and inequalities in tech access

On day 4 of our professional conference (DUKPC) scientists have shared important findings and insights around children and young people with type 1 diabetes.

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Artificial intelligence spots type 1 diabetes in children earlier

Our research Dr Julia Townson has presented research showing a predictive tool using artificial intelligence could provide hope for earlier diagnosis of type 1 diabetes in children across, reducing the risk of diabetic ketoacidosis (DKA) - a serious complication that needs hospital treatment and can be life-threatening. 

A quarter of children and young people aren’t diagnosed with type 1 diabetes until they are in DKA, but spotting diabetes early can help to avoid this.

With funding from Diabetes UK, Dr Townson and her team used artificial intelligence and electronic health records to develop a predictive tool. The tool was trained on data from 1 million children to detect patterns in children’s GP records that could signal they have undiagnosed type 1 diabetes.

The team tested different combinations of factors from GP records, such as urinary infections or bedwetting, family history of type 1 diabetes and being prescribed antibiotics, to discover which could best predict a diagnosis of type 1 diabetes.

To see if the predictive tool could correctly spot children already diagnosed with type 1 diabetes, researchers then assessed how well it worked using GP and hospital records from another 1.5 million children.

They found the tool successfully identified 75% of children who would go on to develop type 1 in the following 90 days. On average, it would have allowed children to be diagnosed – and started on life-saving insulin therapy – 11 days earlier than they were, which could be the difference between life and death for someone.

Further work is now needed to test the new tool with GPs and in patients in primary care to see if could be widely used.

 

Dr Lucy Chambers, Head of Research Communications at Diabetes UK, said:

Type 1 diabetes isn’t currently preventable and is an extremely serious condition. If left undiagnosed, it can progress and lead to dangerous complications very quickly, so finding a way to catch the condition and treat it early could help to avoid emergency hospital treatment and save lives.

“This research, funded by Diabetes UK, could in the future be used by the NHS to help alert GPs to the possibility of a child developing type 1 diabetes, helping more children get an accurate and rapid diagnosis, and have the best possible start to life with type 1 diabetes.”

Dr Julia Townson, Senior Research Fellow at Cardiff University’s Centre for Trials Research, said:

We are now looking to see how this tool might work with primary care computer systems. If possible, this would enable us to carry out a feasibility study to assess the acceptability of the tool with GPs. Use of the tool may be some years away yet – but we are hopeful it will provide a vital new avenue for early diagnosis of diabetes which could save lives.”

In the future this research could be used by the NHS to help alert GPs to the possibility of a child developing type 1 diabetes, providing a vital new avenue for early diagnosis which could save lives.

Inequalities for children with type 1

Dr May Ng spoke about health inequalities and worsening access to diabetes technology based on ethnicity and deprivation in children and young people with type 1 diabetes.

She presented data that was first released last year which found that children and young people with type 1 diabetes from ethnic minority backgrounds are more likely to have higher average blood sugar levels (HbA1c) compared to White children. Black children and young people were found to have the highest average HbA1c levels, followed by children with a Mixed ethnic background and Asian children, and then White children, respectively.

Children in the most deprived areas are more likely to have higher average HbA1c levels than those in less deprived areas.

Diabetes technologies, like continuous glucose monitors (CGMs) and insulin pumps, help people with diabetes to manage their condition and have been shown to help lower blood sugar levels. But Dr Ng's research showed that technology use is lowest in children and young people from socially deprived areas and from ethnic minority backgrounds.

Research to reveal barriers

There is an urgent need to better understand all the reasons why these inequalities exist, in order to take all the necessary steps to address them. Dr Ng is chair of our Diabetes Research Steering Group (DRSG) which focuses on children and young people with diabetes.

The DRSGs bring together scientists, healthcare professionals and people living with diabetes to identify areas where not enough research is happening and then make a plan to stimulate research in these areas.

The DRSGs are now working with leading diabetes research, in partnership with us and JDRF, to develop research to reveal barriers to access to diabetes technology. Research into these issues will take time but in the longer-term, this work will help to close the gap on unacceptable, widening inequalities.

Read our response when this data was first announced last year.

 

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