Investigators: Dr Aveni Haynes, Professor Liz Davis, Ms Alison Roberts, Ms Alex Tully
Project description
Type 1 diabetes is classically regarded as a metabolic disorder diagnosed when the symptoms of persistently high blood glucose levels appear. The clinical presentation, however, follows an extended period of months to years when the immune system attacks the insulin producing cells in the pancreas. Prospective longitudinal studies of older children at genetic risk of type 1 diabetes have shown that impaired glucose homeostasis starts much earlier than symptomatic diabetes. A gradual decline in insulin secretion and beta cell sensitivity can be detected at least two years before the onset of clinical symptoms, and these changes become more rapid in the last few months prior to diagnosis. Higher glucose levels and increased glycaemic variability are also detectable prior to the onset of clinical type 1 diabetes. This recent recognition that type 1 diabetes progresses in these three distinct stages has led to a paradigm shift that re-defines type 1 diabetes as an autoimmune beta cell disorder (ABCD) with clear characteristics associated with Stage 1, Stage 2 and Stage 3 (symptomatic) disease.
The purpose of this sub-study is to undertake serial measurements of continuous glucose monitoring (CGM) data in the Environmental Determinants of Islet Autoimmunity (ENDIA) protocol that will provide the longitudinal data required to define the transition in islet autoantibody-positive children from normoglycaemia (Stage 1 T1D) to dysglycaemia (Stage 2 T1D). Moreover, it will enable characterisation of asymptomatic hyper- or hypo-glycaemia and inform clinical care for such children prior to onset of symptomatic clinical T1D (Stage 3 T1D).
Project outputs
Following data analysis, the results will be written up for presentation and publication at relevant scientific meetings and in peer-reviewed journals. Participants will be notified of study findings via the ENDIA Facebook page, website, and using the regular newsletter that is emailed to participants each quarter.
External collaborators
- Jenny Couper, University of Adelaide/ Women’s and Children’s Hospital, South Australia
- Len Harrison, Walter and Eliza Hall Institute, Victoria
- A/Prof. Maria Craig, University of NSW / Children’s Hospital at Westmead, New South Wales
- Grant Morahan, University of WA, Western Australia
- Peter Colman, Royal Melbourne Hospital, Victoria
- Dr John Wentworth, Walter and Eliza Hall Institute / Royal Melbourne Hospital, Victoria
- A/Prof. Tony Papenfuss, Walter and Eliza Hall Institute, Victoria
- Bill Rawlinson, University of NSW / Prince of Wales Hospital, New South Wales
- Jodie Dodd, University of Adelaide, South Australia
- Dr Lynne Giles, University of Adelaide, South Australia
- A/ Prof. Simon Barry, University of Adelaide, South Australia
- Richard Sinnott, University of Melbourne, Victoria
- A/Prof. Andrew Cotterill, Mater Health Service, Queensland
Funders
- Diabetes Research WA
- JDRF
- Helmsley Trust