About 140,000 Australian children have type 1 diabetes (T1D), and an average of three children are diagnosed every day. These children need lifelong daily insulin treatment to stay alive.
But a world-first study led by Dr Aveni Haynes at Telethon Kids’ Rio Tinto Children’s Diabetes Centre, is helping to detect early changes in blood sugar levels that occur before very young children are diagnosed with T1D to find the right time to intervene with future treatments to delay or prevent the condition.
Dr Haynes, who heads up the diabetes epidemiology research, started the study in 2021. It is the first-time children under two years of age have being monitored using a small device called a continuous glucose monitor (CGM). The monitor picks up early changes in glucose patterns in children known to be at risk of developing T1D before they have any symptoms, which can start months to years before diagnosis.
Detecting these early changes is vital to help identify children at risk who could be eligible for interventions to delay or prevent the onset of T1D. It also allows time for families and children to learn more about T1D symptoms and when to seek help.
Our work is looking at early changes in the pattern of blood glucose levels in very young children in detail as the CGM will show us what’s happening to these levels whilst they are going about their usual activities.
“We’re using continuous glucose monitors, which are about the size of a 20 or 50 cent coin, that the children wear either on the tummy or just above the upper hipbone. They have a tiny probe that sits just under the skin and measures the sugar levels every five minutes, continuously for up to 10 days.
“We can then look at these glucose measurements to see how the patterns change during the day and night and look for very early signs that their sugar patterns are beginning to look different to what you would expect in a healthy child of that age.
“It’s a new way of looking for changes in blood glucose levels over time whilst at home doing their usual routine, rather than needing to come in for a blood test, which is at a single time point, or having to be fasted beforehand.
“Once we find a child has two or more antibodies, we know the risk of developing T1D in the next 10-years is 70 per cent,” Dr Haynes said.
“Early monitoring and detection of diabetes in a child means they can be seen by doctors before becoming too sick and a management plan can be put in place for them straight away.”
Study offers brighter future for Alex
Even before he was born Alex Chatterton was already doing his bit to help find a cure for type 1 diabetes. Alex’s mother Justine lives with the disease and knows all too well how all-encompassing it can be to manage.
When the opportunity came to sign up her children, Penny, six, and Alex, four, for diabetes research in utero, it was an obvious yes. That was the start of Alex’s diabetes research journey.
Now, the happy four-year-old is part of a world-first CGM study looking at changes in blood sugar patterns in very young children at risk of type 1 diabetes, in the hopes of finding the right to time to intervene with future treatments to delay or prevent the condition.
He is one of 68 participants in the Australia wide CGM study. Like Alex, 42 of the participants have T1D-specific multiple antibodies, meaning the immune process underlying the condition was under way.
The Perth-led study is monitoring children like Alex regularly, using a small device called a continuous glucose monitor (CGM) to pick up early changes in glucose patterns in the children known to be at risk of developing T1D, before they have any symptoms. These can start months to years before they would usually be diagnosed.
Justine said being part of the study had given them the knowledge that Alex was already multiple antibody positive, giving him a much higher risk of developing the condition.
Being aware that Alex is multiple antibody positive has given us the warning that a diabetes diagnosis is most likely going to happen and it can prepare us for his management and prevent him needing major medical intervention at diagnosis.
Did you know?
- Type 1 diabetes is a chronic autoimmune disease that results from the immune system attacking the insulin producing cells of the pancreas
- Currently, type 1 diabetes cannot be prevented but it can be managed by administering insulin, monitoring glucose levels, having a healthy, balanced diet and getting regular physical activity
- In WA, about 160 children are diagnosed with diabetes every year