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Keeping track of people at risk of type 1

Project summary

Autoantibodies are signs in the blood that show the immune system has started to plan an attack on insulin-making beta cells. People who have autoantibodies will almost certainly go on to develop type 1 diabetes. Dr Rachel Besser wants to make a list of everyone in the UK who has autoantibodies. This registry could help researchers to understand what life is like knowing you’re at risk of type 1, as well as connect people at risk with clinical trials testing new treatments that could prevent or delay type 1 diabetes, helping to bring forward the day when they become more widely available.

Background to research

In type 1 diabetes, the immune system attacks and destroys insulin-making beta cells in the pancreas. Warning signs of the attack can begin long before someone develops symptoms of type 1 and is diagnosed. These signs can be detected with a simple blood test that looks for molecules in the blood called islet autoantibodies. Islet autoantibodies are used by the immune system to earmark beta cells for destruction.  

Right now, research studies are screening people for autoantibodies, like ELSA and T1DRA in the UK, to spot those at high risk of developing type 1. Most people (around 97%) will test negative for autoantibodies so will have a low risk of developing type 1 diabetes. But what about those who test positive, and are at high risk?  

Dr Rachel Besser and her team at the University of Oxford want to make a registry, or list, of everyone in the UK with autoantibodies.  

Research aims

Dr Besser and her team will build a database and a website that people can use to join the registry. People who’ve tested positive for autoantibodies from screening studies can sign up, as well as people who’ve been identified by their healthcare team. The team will also work with clinical and research sites, and approach people who’d like to join. 

The aims of the registry are:  

  • To keep in contact with people with autoantibodies, so it's easier for healthcare teams to keep an eye on them and catch the onset of type 1 diabetes as early as possible 
  • To tell them about opportunities to get involved in research testing new treatments, called immunotherapies, that could prevent or delay type 1 diabetes  
  • To understand what it’s like knowing you’re at high risk of type 1, and develop resources to better support people 
  • To collect data on how type 1 diabetes develops and understand why, once diagnosed, different people need different amounts of insulin at different times  

Potential benefit to people with diabetes

Dr Besser’s registry could help us to understand the care and support people at high risk of type 1 need, to give them a ‘softer landing’ into life with the condition. It could also help researchers recruit to clinical trials of immunotherapies, allowing them to test treatments faster and find the ones that work, giving us new ways to slow down the progression of type 1, or even prevent it entirely.  

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