Renuka Dias, PhD, MBBS, highlights feasibility of type 1 diabetes screening in children

In a Contemporary Pediatrics interview, Renuka Dias, PhD, MBBS, consultant pediatric endocrinologists at the University of Birmingham, discussed the findings of the Early Surveillance for Autoimmune Diabetes (ELSA) study, a large UK-based investigation evaluating the feasibility and acceptability of population screening for type 1 diabetes in children. ELSA was the first study in the United Kingdom to test a nationwide early detection approach using a simple dried blood spot test to screen for islet autoantibodies, which can predict progression to insulin-dependent diabetes.

Dias explained that the study assessed not only the technical feasibility of screening, but also the psychosocial impact on families. The screening pathway included home-based dried blood spot testing, confirmatory laboratory testing, and structured education sessions to help families understand results and next steps.

Results published recently demonstrated that this screening program was highly feasible and well tolerated. Nearly all participants with a positive screening result completed the full pathway, including education, and adverse events were rare and minor, typically related to the blood sampling process itself.

Recruitment strategies were also a key focus of the study. Social media and schools were effective for engaging the general population, while community clinics proved especially important for reaching underserved groups, including families from non-White ethnic backgrounds and those experiencing socioeconomic disadvantage. Overall acceptability was extremely high, with 98% of participants reporting satisfaction with the screening process and trust in the study, regardless of their test outcomes.

To date, ELSA has enrolled more than 40,000 participants in just over 3 years, making it the largest pediatric type 1 diabetes screening study in the United Kingdom. Funding has since been secured to expand the research through ELSA 2, which will further evaluate the implementation and broader impacts of general population screening.

Dias emphasized that early detection of type 1 diabetes offers significant clinical benefits. Screening reduces the risk of children presenting with diabetic ketoacidosis at diagnosis, a serious and sometimes fatal metabolic emergency.

Children identified early also tend to have better long-term glycemic control compared with those diagnosed after symptom onset. Importantly, early identification creates opportunities to enroll children in clinical trials or offer emerging disease-modifying therapies that may delay progression to insulin dependence.

While no widespread population screening programs currently exist outside of Italy, Dias noted that targeted screening within type 1 diabetes clinics—particularly among first-degree relatives—may be a practical starting point. Looking ahead, she highlighted the potential role of genetic risk scores to refine screening strategies and support future prevention-focused research aimed at delaying or preventing the onset of autoimmune diabetes.

No relevant disclosures.

References

1. National childhood type 1 diabetes screening is effective and could prevent thousands of emergency diagnoses, UK study shows. University of Birmingham. January 20, 2026. Accessed February 2, 2026. https://www.eurekalert.org/news-releases/1113300
2. Quinn LM, Elliott J, Papanikolaou T, et al. Feasibility of general population screening for type 1 diabetes in the UK: the ELSA study. The Lancet Diabetes & Endocrinology. 2026. doi:10.1016/S2213-8587(25)00363-8