Project summary
It’s possible to identify people who are in the earliest stages of type 1 diabetes by looking for signs in the blood that indicate the immune system has started to attack the pancreas. Professor Parth Narendran is exploring how a programme to screen children for these signs and find out their risk of type 1 diabetes would best work.
The ELSA study will screen 60,000 children using simple blood tests. This will give us vital insights that could help lead to a routine, widespread type 1 diabetes screening programme in the UK. Screening can help to make sure families are forewarned and prepared, so a type 1 diabetes diagnosis doesn't have to start with a crisis. It could also give children the opportunity to access new treatments that delay the need for insulin therapy.
Background to research
Type 1 diabetes develops when the immune system destroys the cells in the pancreas that make insulin. We know this attack begins long before someone develops symptoms and needs to start on insulin therapy.
It’s possible to spot early signs of the attack and identify people who have a high risk of developing type 1 or are already in its earliest, symptomless stages.
Risk of type 1 diabetes rises with the number of different autoantibodies found. For children with two or more autoantibodies, it is almost certain they will eventually need insulin therapy. This is known as early-stage type 1 diabetes.
Research aims
Professor Narendran and his team are running a UK-first study to screen children for type 1 diabetes. It's called the ELSA (EarLy Surveillance for Autoimmune diabetes) study.
They're recruiting 60,000 children, aged 2 to 17 years, across the UK. They’ll test for autoantibodies through a combination of finger stick and standard blood tests.
Children who test positive for autoantibodies and their families will be given support and education on living with type 1 diabetes. And they’ll be closely monitored to help make sure they can start on insulin therapy promptly when needed, reducing the chances of an emergency hospital admission.
The ELSA team will speak to the families and healthcare professionals involved in the study to gather their views on the screening process. They'll also look at how screening can be scaled across the NHS and evaluate its cost-effectiveness. All this will help inform how best to design any potential wider screening programme that could be rolled out through the NHS in the future.
ELSA will also establish new NHS Early-Stage Type 1 Diabetes Clinics, providing families taking part in the study with clinical and psychological support and creating a clear pathway from screening to diagnosis, monitoring and treatment.
Potential benefit to people with diabetes
The ELSA study will give us crucial insights that could help to make screening for type 1 diabetes a reality for every family in the UK.
Currently, over a quarter of children aren’t diagnosed with type 1 diabetes until they are in life-threatening Diabetic Ketoacidosis (DKA). Early detection can dramatically reduce emergency diagnoses and could give children access to new immunotherapy treatments that can delay the need for insulin for years.
The first immunotherapy for type 1 diabetes was licensed in the UK in 2025. A screening programme will be essential to make sure such treatments reach as many people as possible who could benefit.
