This World Diabetes Day, we’re excited to announce that recruitment for a world-first research study to identify adults in the general population at high risk of type 1 diabetes is open.
The Type 1 Diabetes Risk in Adults (T1DRA) study is recruiting 20,000 adults, aged between 18 and 70, to find those who are likely to develop type 1 diabetes in the future. It’s led by Professor Kathleen Gillespie at the University of Bristol.
We launched a similar study for children – called ELSA – last year. This means the UK is now the first country in the world to offer type 1 diabetes screening for both children and adults in the general population, in a research setting.
Understanding type 1 diabetes in adults
We know that more than half of type 1 diabetes diagnoses are in adults. But scientists have mostly studied its development in children, so adult-onset type 1 diabetes isn’t well understood.
T1DRA will answer important questions about how type 1 diabetes develops in adults and will give us the first ever picture of how many adults in the UK are at increased risk of developing the condition.
It will also mean that that people found to be at high risk of type 1 diabetes will get support and monitoring, and access to clinical trials testing new preventative treatments.
T1DRA is funded by the Helmsley Charitable Trust and has been made possible by the UK’s longest running study of type 1 diabetes, called Bart's Oxford Family study (BOX), which we’ve funded over the last 40 years.
How does T1DRA work?
People aged 18-70 years in the UK can take part in T1DRA as long as you don’t have type 1 diabetes. You can sign up today and will be sent an at-home testing kit in the post, involving a finger prick blood test.
The research team will then examine the blood samples for signs that the immune system attack that causes type 1 diabetes has begun.
These signs are called islet autoantibodies. They are proteins used by the immune system to earmark insulin-producing cells for destruction. Islet autoantibodies can appear in the blood years, or sometimes decades, before people fully develop type 1 diabetes and experience any symptoms.
Most people (around 97%) will be told they are negative for autoantibodies and aren’t at high risk. Those who are identified as high risk will be followed up by the research team to examine how many develop type 1 diabetes and how quickly they progress to a type 1 diagnosis.
Researchers will also identify which genetic, biological and environmental factors can be linked with type 1 developing quickly.
People at high risk will also be offered:
- Information about the symptoms of type 1 diabetes and its management, along with continued monitoring. This should help people to get the earliest, safest diagnosis possible – avoiding dangerous diabetic ketoacidosis (DKA) – and a ‘soft landing’ into life with type 1.
- Access to clinical trials testing immunotherapies, the newest innovations in type 1 diabetes treatment that are designed to prevent or delay the condition.
One immunotherapy treatment, teplizumab, has been found to slow an immune attack and delay a diagnosis of type 1 diabetes by an average of three years.
It was approved for use in the US in 2022, and is currently being reviewed for approval in the UK.
We’re also supporting scientists to develop and test other immunotherapies for type 1 diabetes, to make sure further treatments follow in teplizumab’s path.
Model Roxy Horner, 32, was diagnosed with type 1 diabetes a month before her 30th birthday.
"I’d been feeling unwell for some time but hadn’t realised that some of my symptoms, such as tiredness and excessive thirst, were among the main warning signs for type 1 diabetes.
"Being taken to A&E and then being diagnosed with type 1 diabetes was such a shock and things have never been the same.
"Diabetes is relentless and as a young Mum, looking after a new baby and managing my condition can be challenging. I wish there had been a better way of preparing me for such life-changing news.
“The T1DRA trial is important because it will help teach us more about people who are diagnosed with type 1 diabetes as adults. I really hope the trial will get us a step closer to a time when it can be spotted early so people can be more prepared.
"Type 1 diabetes can come on at any age and I’d encourage anyone reading this to sign up to the T1DRA trial today.”
Screening for children
One year since the launch of ELSA on World Diabetes Day 2022, 10,000 children have already signed-up for to find out their risk. The team are aiming to recruit a further 10,000 children over the next 18 months. You can find out more and sign up on ELSA’s website.
Dr Elizabeth Robertson, Director of Research at Diabetes UK, said:
“We’re delighted that the pioneering T1DRA programme is now recruiting and hope it will offer a better future for adults at high risk of developing type 1 diabetes. With the ELSA type 1 diabetes screening study actively recruiting children, the UK is at the forefront of research that will bring us closer to the day when risk of type 1 diabetes can be spotted early, and a diagnosis prevented.”