A large UK study suggests that screening children for type 1 diabetes using a simple finger-prick blood test could help identify the condition earlier and prevent some of the most dangerous emergency presentations.
Type 1 diabetes can develop quietly before symptoms become obvious.
When diagnosis comes late, children can become seriously unwell with diabetic ketoacidosis, a life-threatening complication that often requires urgent hospital treatment.
Earlier detection gives families time to prepare and allows clinicians to start monitoring and treatment sooner.
Researchers running the Early Surveillance for Autoimmune diabetes study – known as ELSA – have already screened more than 17,000 children aged three to 13.
The test checks for autoantibodies, proteins made by the immune system that can mistakenly target the body’s own tissues.
In type 1 diabetes, these autoantibodies attack the pancreas, which produces insulin.
One of the children identified through screening is Imogen, aged 12, from the West Midlands.
Her mother described the impact of knowing in advance – it changed the family’s confidence and sense of control.
Rather than being thrown into an emergency, they had warning and support.
For some children, early detection may also open the door to treatments intended to delay progression.
Imogen is trying an immunotherapy drug called teplizumab, designed to calm the immune attack on the pancreas and slow the move towards insulin dependence.
Clinical trials have suggested it can delay onset by around three years on average, although it is not yet widely available on the NHS.
The early results from ELSA show a range of outcomes.
Some children had one autoantibody, signalling increased future risk. Others had two or more autoantibodies but did not yet need insulin, consistent with early-stage type 1 diabetes.
A small number were found to have undiagnosed type 1 diabetes and needed to start insulin immediately.
Children without autoantibodies were considered unlikely to go on to develop type 1 diabetes.
Researchers and charities backing the study argue that these findings strengthen the case for wider screening.
The next phase – ELSA 2 – will expand the offer to children aged two to 17, with testing possible at home, in school or at a GP surgery.
Whether the UK adopts universal screening would be a decision for ministers, advised by the UK National Screening Committee and evidence from studies like ELSA.
Several other countries are exploring similar approaches and Italy has already introduced screening for children and young people.
