Columbia University, as a participant in national research aimed at earlier diagnosis of type 1 diabetes, is offering free screening to qualified relatives of people with the disease.
Too often type 1 diabetes is discovered in the emergency room, when a patient has life-threatening complications, such as diabetic ketoacidosis. Prevention research such as the NIH TrialNet Pathway to Prevention Research Study for Relatives of People with Type 1 Diabetes has cut the risk of diabetic ketoacidosis from 30 percent to less than 4 percent.
As a member of TrialNet, Columbia’s Naomi Berrie Diabetes Center offers screening for type 1 diabetes to all qualified relatives of people with the disease. Family members of those with the disease are the best candidates for screening: They have a 15 times greater risk of being diagnosed with type 1 diabetes than a person with no family history.
Robin Goland, MD, co-director of the Berrie Center and the J. Merrill Eastman Professor of Diabetes (in Medicine, Pediatrics, and the Naomi Berrie Diabetes Center), is principal investigator at Columbia of TrialNet. “TrialNet’s goal is to identify the disease at its earliest stage, delay progression, and ultimately prevent it,” says Dr. Goland. “We offer screening and clinical trials for every stage of type 1 diabetes and close monitoring for disease progression.”
Screening at the Berrie Center is available at no charge to
- anyone between the ages of 1 and 45 who has a sibling, child, or parent with type 1 diabetes.
- anyone between the ages of 1 and 20 who has a sibling, child, parent, cousin, uncle, aunt, niece, nephew, grandparent, or half-sibling with type 1 diabetes
The trial recommends that children who do not test positive for diabetes-related autoantibodies continue to get rescreened every year until they reach age 18.
In stages 1 and 2 of type 1 diabetes, the lifetime risk of developing type 1 diabetes approaches 100 percent.
Drawing from two decades of TrialNet studies of 150,000 relatives of people with type 1 diabetes, several organizations devoted to diabetes research and care have recommended a new system for staging of type 1 diabetes:
Stage 1: Individuals test positive for two or more diabetes-related autoantibodies, meaning the immune system has begun attacking the insulin-producing beta cells, although blood sugar remains normal and no symptoms are present.
Stage 2: Individuals have two or more diabetes-related autoantibodies, but now blood sugar levels have become abnormal due to increasing loss of beta cells. Individuals at stage 2 are still symptom-free.
Stage 3: A clinical diagnosis is made. By now, blood shows significant beta cell loss and individuals generally show common symptoms of type 1 diabetes, which include frequent urination, excessive thirst, weight loss, and fatigue.
For both stages 1 and 2, the lifetime risk of developing type 1 diabetes approaches 100 percent.
The new stages, the authors wrote in the Jan. 16 issue of Diabetes Care, show how the disease progresses and will help allow earlier diagnosis and intervention.
Anyone eligible for free screening should contact the Naomi Berrie Diabetes Center at 212-851-5425 or via email (email@example.com).