ESPE2023 Rapid Free Communications Diabetes and insulin 1 (6 abstracts)
3 Screen ICA ELISA–A new tool to identify pre-clinical diabetes in first-degree relatives of patients with type 1 diabetes (pre-d1abetes study)
Artur Bossowski 1 , Klaudyna Noiszewska 1 , Agnieszka Polkowska 1 , Aneta Zasim 2 , Milena Jamiolkowska 1 , Malgorzata Mysliwiec 3 , Agnieszka Szadkowska 4 , Artur Mazur 5 , Przemyslawa Jarosz-Chobot 6 , Agnieszka Szypowska 7 , Agata Chobot 8 , Joanna Nazim 9 , Agnieszka Zubkiewicz 10 , Iwona Ben-Skowronek 11 , Elzbieta Niechcial 12 , Mieczyslaw Walczak 13 , Anita Jozwa 13 , Marta Mincewicz-Wysocka 14 , Katarzyna Robak-Kotna 15 , Shu Chen 16 , Jadwiga Furmaniak 16 & Bernard Smith 17
1Medical University in Bialystok, Bialystok, Poland. 2Children University Hospital in Bialystok, Bialystok, Poland. 3Gdansk Medical University, Gdansk, Poland. 4Medical University in Lodz, Lodz, Poland. 5Rzeszow Medical University, Rzeszow, Poland. 6Silesian Medical University, Katowice, Poland. 7Medical University in Warszawa, Warsaw, Poland. 8Opole Medical University, Opole, Poland. 9Jagiellonski Medical University in Krakow, Krakow, Poland. 10Medical University in Wroclaw, Wroclaw, Poland. 11Medical University in Lublin, Lublin, Poland. 12Medical University in Poznan, Poznan, Poland. 13Pomorian Medical University in Szczecin, Szczecin, Poland. 14Memorial Institute of Healthy Children, Warsaw, Warsaw, Poland. 15Medical University in Bydgoszcz, Bydgoszcz, Poland. 16FIRS LAB RSR Ltd, Cardiff, United Kingdom. 17FIRS LAB RSR Ltd., Cardiff, United Kingdom
Introduction: Overt clinical symptoms of type 1 diabetes (T1D) are often preceded by a pre-clinical stage of varying duration. Diagnosis of the pre-clinical stage is difficult and is based on the presence of specific islet autoantibodies in the subject's blood. Objectives: Apparently healthy first-degree relatives of patients with T1D were tested using the 3 Screen ICAELISA (RSR Ltd) for combined testing for autoantibodies to GAD65 (glutamic acid decarboxylase, 65 kDa isoform), ZnT8 (zinc transporter 8), and the islet antigen IA-2. A 3 Screen positives were subsequently tested for individual auto anti bodies. Potentially, approximately 70% of individuals with two or more types of diabetes associated auto anti bodies (including insulin auto anti bodies; IAA) will need insulin treatment over the next 10 years.
Methods: A total of 1227 subjects (age 1–18 years) were recruited from clinical Centers from Białystok (n= 237), Rzeszow (n= 80), Poznan (n= 74), Warsaw IP-CZD (n= 147), Warsaw WUM (n= 42), Opole (n= 106), Wrocław (n= 90), Gdansk (n= 55), Łódź (n= 165), Katowice (n= 46), Krakow (n= 14), Szczecin (n= 20), Bydgoszcz (n= 73), Lublin (n= 42). Serum samples collected by the coordinating clinics were tested by 3-Screen at FIRS Laboratories, RSR Ltd (Cardiff, UK). A 3 Screen positive serum samples were also assayed by GAD65 Ab ELISA, IA-2 Ab ELISA, ZnT8 Ab ELISA and the Insulin Ab RIA (www.rsrltd.com).
Results: Out of 1227 samples n= 105 (8.5%) were 3 Screen positive. Testing in individual autoantibody assays identified 70 children (5.7%) with multiple auto anti bodies who were diagnosed with pre-clinical diabetes. These children were followed-up with a normal glucose tolerance test and glycated hemoglobin determinations. Conclusions: Early detection of islet autoantibodies by 3 Screen identifies pre-clinical T1D preceding development of carbohydrate abnormalities. This open sup opportunities for the therapeutic interventions in innovative clinical programs. Patient follow up with early education and multidirectional diabetes care should prevent occurrence of ketoacidosis associated with severe clinical manifestations.
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