AURORA | Victoria Gage knows how irritating it can be to prick her fingers between six and eight times a day to test her blood sugar levels. She wears a continuous glucose monitor that pumps insulin into her body when her blood sugars are high, and doesn’t know any other way of living.
That’s why she’s adamant about testing her 4-year-old daughter for the autoimmune disease each year, because Katelyn is 15 times more likely to get the disease than someone with no family history of it.
“I’d want to do everything possible to try and prevent that in her,” said Gage, who is a registered nurse and research coordinator at the Barbara Davis Center for Diabetes on the Anschutz Medical Campus.
Under the Barbara Davis Center’s TrialNet Pathway to Prevention Study, relatives of people with Type 1 diabetes can be screened for the autoimmune disease for free and participate in two ongoing prevention studies.
The screenings, which involve drawing blood and testing for four auto-antibodies that are specifically correlated to the progression of Type 1 diabetes, have been offered for the past 11 years as part of the international study.
The Barbara Davis Center is one of more than a dozen clinics across the world that are screening relatives for free. The program is funded through a grant from the National Institutes of Health.
Over the past 11 years, the TrialNet study has screened more than 100,000 people, including the 1,500 people screened annually at the Barbara Davis Center, said Hannah Goettle, clinical research coordinator for the TrialNet Pathway to Prevention Study.
About 4 percent to 6 percent of people screened test positive for the autoantibodies. But that doesn’t necessarily mean they automatically have Type 1 diabetes.
The autoantibodies can appear in the person’s bloodstream up to seven years before a Type 1 diabetes diagnosis, Goettle said.
If a person does test positive for the autoantibodies, doctors then give them an oral glucose tolerance test which essentially involves feeding them a syrupy drink to see how well the body is producing insulin, she said.
If the body isn’t producing insulin very well, that’s a sign that the person could eventually develop Type 1 diabetes, in which the immune system attacks and destroys the cells in the body that produce insulin.
People with these autoantibodies then have a choice of participating in two studies under the TrialNet program.
“The whole point of this is to get into prevention studies,” Goettle said.
The ongoing prevention studies are the Oral Insulin Prevention Study, in which participants ingest an insulin capsule that’s been shown to prevent or delay Type 1 diabetes for up to 10 years, and the Anti-CD3 Prevention Study, which tests whether an experimental drug called teplizumab can prevent or delay the disease.
Goettle said the screenings have proven to be successful in identifying potential Type 1 diabetes patients early on.
“It’s nice for parents because they can make sure their children don’t have those autoantibodies, and if they did then we have these opportunities to at least delay the onset and hopefully find prevention,” she said.
Gage said the free screenings and studies available for people are life changing. Gage was diagnosed with the autoimmune disease at age 7, only three years older than her daughter is now.
“I think this is huge,” she said. “I think this is how we’ll eventually prevent diabetes.”
About 5,000 people are living with Type 1 diabetes in Colorado, and about 3 million people have it nationwide, said Peter Chase, professor of pediatrics at the University of Colorado School of Medicine.
That means there are thousands of other relatives — including immediate and extended family members — who are at risk of developing the illness as well.
“Eventually, if we’re ever going to prevent diabetes for these family’s children or grandchildren, families have to participate in the research,” Chase said.
If a person is screened for the autoantibodies and then followed closely by medical professionals, they are less likely to end up in the hospital with diabetic ketoacidosis, a severe shortage of insulin that causes intense dehydration and even death.
If a relative of a family member with Type 1 diabetes is not screened for the disease, they are 33 percent more likely of ending up in the hospital with diabetic ketoacidosis, Chase said.
The cases of Type 1 diabetes are increasing between 3 percent and 5 percent year after year, especially in children under the age of 5, he said. He expects that in the near future, doctors will begin testing all children for the autoantibodies that are correlated to the progression of Type 1 diabetes.
“I think we’ll be screening every preschool child in the United States, not just family members of people with Type 1 diabetes,” Chase said.
To schedule a free screening, call 1-800-572-3992.
Reach reporter Sara Castellanos at 720-449-9036 or firstname.lastname@example.org.