BSPED2023 Poster Presentations Diabetes 3 (12 abstracts)
EarLy Surveillance for Autoimmune type 1 diabetes (ELSA) – paediatric, general population screening in the UK
Shivam Choudhary 1 , Lauren Quinn 2 , David Stanley 3 , Renuka Dias 4 , R Rashid 5 , J Garstang 6 , D Shukla 7 , Sheila Greenfield 8 , Alex Richter 9 & Parth Narendran 10
1University of Birmingham, Birmingham, UK; 2Institute of immunology and Immunotherapy, University of Birmingham, Birmingham, UK; 3Queen Elizabeth Hospital Birmingham, Birmingham, UK; 4Department of Diabetes, Birmingham Children’s Hospital, UK; INNODIA Principle Investigator, Birmingham Children’s Hospital, Birmingham, UK; 5School of Medicine, Dentistry and Nursing, University of Glasgow, Glasgow, UK; 6Birmingham Community Healthcare Trust, Birmingham, UK; 7Clinical Research Lead for Primary Care (West Midlands), Birmingham, UK; 8Institute of Applied Heath Research, University of Birmingham, Birmingham, UK; 9Head of Clinical Immunology Service, University of Birmingham, Birmingham, UK; 10Institute of immunology and Immunotherapy, University of Birmingham; Department of Diabetes, University Hospitals of Birmingham, Birmingham, UK
Background: Children with pre-symptomatic type 1 diabetes (T1D) can be identified through testing for circulating islet autoantibodies (AAb). Identifying children at risk reduces diabetic ketoacidosis at onset and allows participation in trials aiming to delay disease onset. Teplizumab is the first immunomodulatory agent licensed in the US to delay the onset of T1D by 3 years in individuals at risk; a licensing decision is awaited in the UK. The EarLy Surveillance for Autoimmune diabetes (ELSA) study is exploring the feasibility and acceptability of UK paediatric general population screening.
Methods: The ELSA study runs from July 2022 to August 2024 and aims to recruit 20 000 children aged 3–13 years. Families are invited via social media and through community settings including schools and general practice. ELSA is screening for AAb via dried blood spot (DBS) and subsequent staging via oral glucose tolerance testing. ELSA is exploring the feasibility and acceptability of UK paediatric general population screening.
Results: In total, 6932 children have consented, including 6488 children for home testing and 444 for screening in community settings. Families are principally White European (92%) and 54% have a family history of T1D. Thus far, 3939 kits have been returned and analysed with 3833 children screening negative and 91 screening positive for AAb. Thus far, 5 DBS kits had insufficient sample and 10 blank cards have been returned. On confirmatory AAb testing, 5 children are false positive (7%), 20 are single (27%) and 49 (66%) are multiple AAb positive. One child at stage 3 was referred immediately into paediatric diabetes clinical service. Of the remaining multiple AAb children, 35 are stage 1, 2 are stage 1 and 11 await staging. All multiple AAb families agreed to confirmatory testing, staging and education and have expressed interest in INNODIA for monitoring.
Conclusion: Social media is an effective route to recruitment for home testing. Community outreach to schools and general practices is underway. Exploring acceptability and barriers to screening are key outcomes for this study. Qualitative interviews will explore the harms and psychological implications of screening on parents.
Volume 95
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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