ANN ARBOR, MI – Anyone who has seen a young relative cope with a new diagnosis of type 1 diabetes – or an adult relative handle the daily demands of the lifelong illness – knows what a toll it can take.
Now, it’s even easier than ever for relatives of type 1 diabetes patients to help University of Michigan Comprehensive Diabetes Center researchers in the search for ways to prevent or delay the disease.
Starting this week, people with a family history of type 1 diabetes (also sometimes called juvenile diabetes) can conveniently participate in free online screening.
The screening will help identify people who may qualify to take part in studies at U-M or other sites – no matter where they live. This alternative to in-person initial screening comes as modern technology enables more secure online registration for medical research.
The screening, consisting of a web questionnaire and blood test, is for Type 1 Diabetes TrialNet (www.diabetestrialnet.org), a National Institutes of Health-funded long-term international collaboration, of which U-M is a part.
The effort is aimed at discovering ways to delay or prevent type 1 diabetes in people at increased risk.
TrialNet must screen more than 20,000 relatives of people with type 1 diabetes each year to perform studies to reach its research goals.
Previously, relatives needed to visit a study site in person, or attend a screening event. But now, after answering a few questions online at www.Pathway2Prevention.org, eligible volunteers will receive a kit in the mail, and be directed to a local lab for screening at no cost to the volunteer.
People who have antibodies associated with the development of type 1 diabetes will be contacted by a TrialNet center to review the results. They may be invited to have more blood tests at U-M or another study center, and may be invited to join a study aimed at preventing or delaying the disease.
Children under 18 years old who do not have the antibodies can be retested annually to see if their risk has changed. Of every 100 people tested, typically only 3 or 4 will have antibodies showing an increased risk for type 1 diabetes.
“By ensuring the safety of people’s personal information while also making it easier to participate in clinical trials, we hope to find more people who are at risk and want to help find ways to delay or prevent type 1 diabetes,” said TrialNet Program Director Ellen Leschek, M.D., of the NIH’s National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), which oversees the trial.
Type 1 diabetes, once called juvenile diabetes, develops when the body's immune system mistakenly destroys the insulin-producing beta cells of the pancreas. Insulin, a hormone, is needed to convert glucose (sugar) into energy.
People with type 1 diabetes need insulin by daily injections or a pump to survive. However, replacing insulin is not a cure, and the disease may eventually damage the eyes, nerves, kidneys, and blood vessels. In adults, type 1 diabetes accounts for about 5 percent of the approximately 19 million people diagnosed with diabetes. Type 1 diabetes is not associated with obesity.
TrialNet studies have already helped. People at risk for type 1 diabetes who participated in TrialNet's Pathway to Prevention Study were more likely to be diagnosed early. Early diagnosis means patients are less likely to develop diabetic ketoacidosis, a life-threatening condition. Early diagnosis also means patients can often control their diabetes more quickly, which may slow the loss of insulin-producing cells and may delay complications.
“For people with type 1 diabetes, the importance of early diagnosis cannot be overstated,” said Massimo Pietropaolo, M.D., the principal investigator of U-M’s participation in TrialNet. “We hope that individuals who have seen the impact of type 1 diabetes in their relatives will join with us on this effort.”
Pietropaolo is a professor at the U-M Medical School in the departments of Internal Medicine; Pediatrics and Communicable Diseases; and Microbiology & Immunology. He directs the Laboratory of Immunogenetics, and is a U-M Brehm Investigator in the Brehm Center for Diabetes Research. Other U-M researchers involved are Inas Thomas, M.D.; Charles Burant M.D., Ph.D.; Rodica Pop-Busui, M.D., Ph.D.; Ming Chen, M.D., Ph.D.; and Ram Menon, M.D. Catherine Martin, MS, RN, CDE, serves as trial coordinator.
Launched in 2001, TrialNet has also demonstrated that two drugs, Rituximab and Abatacept, slow the loss of insulin production in people with new-onset type 1 diabetes. This finding could improve diabetes control and delay complications. TrialNet has also contributed to research showing that anti-CD3, an immunosuppressive drug, can slow loss of insulin production. Three prevention studies are ongoing.
TrialNet (NCT00097292) is a network of 18 clinical centers working in cooperation with more than 200 sites throughout the United States, Canada, Finland, Britain, Italy, Germany, Australia and New Zealand. TrialNet is funded by NIDDK and other NIH components, including the National Institute of Allergy and Infectious Diseases and the Eunice Kennedy Shriver National Institute of Child Health and Human Development, as well as the Juvenile Diabetes Research Foundation and American Diabetes Association.
For more information on diabetes, including type 1, visit http://diabetes.niddk.nih.gov/.
For more information on diabetes research at U-M, visit the Michigan Comprehensive Diabetes Center http://www.med.umich.edu/diabetes.