Early Diagnosis & Staging of Type 1 Diabetes, and Phenotyping

Type 1 diabetes can be diagnosed at an early presymptomatic stage by the detection of islet autoantibodies. 

The world's first population-based screening study for an early diagnosis of type 1 diabetes in children has been conducted in Bavaria since 2015 as the "Fr1da study: Early diagnosis and care of type 1 diabetes”. The aim of this study is to diagnose type 1 diabetes at a presymptomatic early stage and to provide affected children and families with a teaching, education and follow up program in order to prevent severe metabolic decompensation at clinical manifestation of type 1 diabetes.

In addition, the development and progression of islet autoimmunity is characterized in more detail by large birth cohort studies (BabyDiab study, BabyDiet study, Teddy study) with a prospective intensive follow-up from birth of up to 4000 at risk children (familial predisposition or genetic risk) and by a large type 1 diabetes early stage cohort with over 400 children (Fr1da cohort study). For the different stages of type 1 diabetes pathogenesis, the specific autoantibody profiles/autoantibody characteristics will be defined and investigated.

Thus, pathogenetically relevant immunization and progression patterns can be identified and associated with genetic, demographic, exogenous and metabolic factors. The knowledge gained could significantly contribute to a better understanding of relevant targets, etiological factors as well as mechanisms in the autoimmune process of type 1 diabetes and thereby support the development of effective immunotherapies for the prevention of type 1 diabetes. Furthermore, new predictive markers/profiles for the stratification of progression rates from early stage to clinically manifest type 1 diabetes could allow a targeted selection of suitable participants for clinical trials and result in the development of new diagnostic test methods.