ObjectiveType 1 diabetes (T1D) screening programmes testing islet autoantibodies (IAbs) in childhood can reduce life-threatening diabetic ketoacidosis. General population screening is required to detect the majority of children with T1D, since in >85% there is no family history. Age 3-5 years has been proposed as an optimal age for a single screen approach.DesignCapillary samples were collected from children attending their preschool vaccination and analysed for IAbs to insulin, glutamic acid decarboxylase, islet antigen-2 and zinc transporter 8 using radiobinding/luciferase immunoprecipitation system assays. Acceptability was assessed using semistructured interviews and open-ended postcard questionnaires with parents.SettingTwo primary care practices in Oxfordshire, UK.Main outcome measuresThe ability to collect capillary blood to test IAbs in children at the routine preschool vaccination (3.5-4 years).ResultsOf 134 parents invited, 66 (49%) were recruited (median age 3.5 years (IQR 3.4-3.6), 26 (39.4%) male); 63 provided a sample (97% successfully), and one participant was identified with a single positive IAb. Parents (n=15 interviews, n=29 postcards) were uniformly positive about screening aligned to vaccination and stated they would have been less likely to take part had screening been a separate visit. Themes identified included preparedness for T1D and the long-term benefit outweighing short-term upset. The perceived volume of the capillary sample was a potential concern and needs optimising.ConclusionsCapillary IAb testing is a possible method to screen children for T1D. Aligning collection to the preschool vaccination visit can be convenient for families without the need for an additional visit.
10.1136/archdischild-2023-326697
Journal article
2024-09-01T00:00:00+00:00
109
812 - 817
5
JDRF/Wellcome Diabetes and Inflammation Laboratory, Centre for Human Genetics, Nuffield Department of Medicine, Oxford NIHR Biomedical Research Centre, University of Oxford, Oxford, UK.
Islets of Langerhans, Humans, Diabetes Mellitus, Type 1, Glutamate Decarboxylase, Autoantibodies, Mass Screening, Vaccination, Parents, Child, Preschool, Female, Male, Receptor-Like Protein Tyrosine Phosphatases, Class 8, Proof of Concept Study, Zinc Transporter 8