ESPE2022 Poster Category 1 Diabetes and Insulin (86 abstracts)
3 Screen ICA TM Elisa - A New Tool for Identify Pre-Clinical Diabetes in First-Degree Relatives of Patients with Type 1 Diabetes (Pre-D1Abetes Study)
Klaudyna Noiszewska 1 , Artur Bossowski 1 , Aneta Zasim 1 , Milena Jamiołkowska-Sztabkowska 1 , Agnieszka Polkowska 1 , Artur Mazur 2 , Marta Brzuszek 3 , Piotr Fichna 4 , Elżbieta Niechciał 4 , Mieczysław Szalecki 5 , Marta Wysocka-Mincewicz 5 , Małgorzata Myśliwiec 6 , Magdalena Żalińska 6 , Małgorzata Szmigierko-Kawko 6 , Anna Noczyńska 7 , Agnieszka Zubkiewicz-Kucharska 7 , Agata Chobot 8 , Karolina Górska-Flak 8 , Agnieszka Ochab 8 , Agnieszka Szadkowska 9 , Krystyna Wyka 9 , Iwona Pietrzak 9 , Olgierd Pilecki 10 , Przemysława Jarosz-Chobot 11 , Ewa Rusak 11 , Iwona Beń-Skowronek 12 , Joanna Sieniawska 12 , Agnieszka Szypowska 13 , Joanna Nazim 14 , Mieczysław Walczak 15 , Anita Jóźwa 15 , Katarzyna Marcinkiewicz 15 , Michael Powell 16 , Marie Amoroso 16 , Bernard Rees Smith 16 & Jadwiga Furmaniak 16
1Medical University of Bialystok, Department of Pediatrics, Endocrinology, Diabetology with Cardiology Division, Białystok, Poland; 2Medical University of Rzeszów, II Department of Pediatrics, Pediatric Endocrinology and Diabetology, Rzeszów, Poland; 3Medical Uniwersity of Rzeszów, II Department of Pediatrics, Pediatric Endocrinology and Diabetology, Rzeszów, Poland; 4Medical University of Poznań, Department of Diabetology and Obesity of Developmental Age, Poznań, Poland; 5IP CZD in Warsaw, Department of Pediatrics, Endocrinology and Diabetology, Warsaw, Poland; 6Medical University of Gdańsk, Department and Clinic of Pediatrics, Diabetology and Endocrinology, Gdańsk, Poland; 7Department and Clinic of Endocrinology and Diabetology of the Developmental Age, Wrocław, Poland; 8Institute of Medical Sciences, University of Opole, Department of Pediatrics, Opole, Poland; 9Medical University of Lodz, Department of Pediatrics, Diabetology, Endocrinology and Nephrology, Łódź, Poland; 10Józef Brudziński Children's Hospital in Bydgoszcz, Department of Pediatrics, Endocrinology and Diabetology, Bydgoszcz, Poland; 11Medical University Of Silesia SUM, Katowice, Poland, Department of Children's Diabetology, Katowice, Poland; 12University Children's Hospital in Lublin, Department of Pediatric Endocrinology and Diabetology with Endocrine and Metabolic Laboratory, Lublin, Poland; 13Medical University of Warsaw, Clinical Subdivision of Pediatric Diabetology and Pediatrics, II Department of Pediatrics, Warsaw, Poland; 14Collegium Medicum Kraków, Department of Endocrinology of Children and Youth, Department of Pediatrics, Kraków, Poland; 15Pomeranian Medical University, Department of Pediatrics, Endocrinology, Diabetology, Metabolic Diseases and Cardiology of The Developmental Age, Szczecin, Poland; 16FIRS Laboratories, RSR Ltd, Cardiff, FIRS Laboratories, RSR Ltd., Cardiff, United Kingdom
Background and Aims: A pre-clinical stage of type 1 diabetes (T1D) often precedes by many years the overt clinical symptoms. Diagnosis during this period is often difficult and is based on the presence of specific islet autoantibodies in the subject's blood. First-degree relatives of patients with T1D were tested using the 3 Screen ICA TM ELISA (RSR Ltd) for combined testing for autoantibodies to GAD65 (glutamic acid decarboxylase, 65kDa isoform), ZnT8 (zinc transporter 8), and the islet antigen IA-2. 3 Screen positives were subsequently tested for individual antibodies. Potentially, approximately 70% of individuals with two or more types of autoantibodies (including IAA, anti-insulin) will need insulin treatment over the next 10 years.
Methods: Clinical Centers from Białystok (n=237), Rzeszów (n=80), Poznań (n=74), Warsaw IP-CZD (n=109), Warsaw (n=42), Opole (n=85), Wrocław (n=90), Gdańsk (n=55), Łódź (n=118), Katowice (n=46), Kraków (n=14), Szczecin (n=20), Bydgoszcz (n=44), Lublin (n=42) participated in the study, a total of 1056 patients (age 1-18). Blood was sent to the coordinating clinic and forwarded to FIRS Laboratories, RSR Ltd (Cardiff, UK) for testing. 3 Screen positive serum samples were assayed in the GAD65 Ab ELISA, IA-2 Ab ELISA, ZnT8 Ab ELISA and the Insulin Ab RIA (www.rsrltd.com).
Results: Out of 1056 samples n=85 (8,04%) were 3 Screen positive, 59 children with multiple autoantibodies were identified as pre-clinical diabetes (5,58%). As follow-up oral glucose tolerance test and glycated hemoglobin were performed.
Conclusions: Early detection of islet autoantibodies by 3 Screen identifies pre-clinical T1D preceding carbohydrate abnormalities and give the possibility of therapeutic interventions in innovative clinical programs. Patients covered by early education and multidirectional diabetes care will avoid the severe clinical condition associated with ketoacidosis.
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