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Updated: Jun 22, 2025
A High-Throughput Multiplexed Screening for Type 1 Diabetes, Celiac Diseases, and COVID-19
Published on: July 5, 2022
General population screening for type 1 diabetes using islet autoantibodies at the preschool vaccination visit: a
Claire Scudder1, Julia Townson2, Jane Bowen-Morris3
1JDRF/Wellcome Diabetes and Inflammation Laboratory, Centre for Human Genetics, Nuffield Department of Medicine, Oxford NIHR Biomedical Research Centre, University of Oxford, Oxford, UK.
Insights
Screening children for type 1 diabetes (T1D) using islet autoantibodies (IAbs) during preschool vaccinations is feasible. This approach is convenient for families and aids early detection of T1D.
Area of Science:
- Pediatric Endocrinology
- Immunology
- Public Health Screening
Background:
- Type 1 diabetes (T1D) screening in children can prevent diabetic ketoacidosis.
- General population screening is essential as most T1D cases lack family history.
- A single screening at ages 3-5 years is proposed as optimal.
Purpose of the Study:
- To evaluate the feasibility of capillary blood sample collection for islet autoantibody (IAb) testing in young children.
- To assess parental acceptability of T1D screening integrated with preschool vaccinations.
- To determine the optimal age for a single T1D screening approach.
Main Methods:
- Capillary blood samples were collected from children aged 3.5-4 years during routine preschool vaccinations.
- Samples were analyzed for multiple islet autoantibodies (IAbs) using radiobinding/luciferase immunoprecipitation system assays.
- Parental acceptability was assessed through interviews and questionnaires.
Main Results:
- Successful capillary sample collection was achieved in 97% of participants.
- One participant tested positive for a single islet autoantibody.
- Parents reported high acceptability for screening integrated with vaccination, citing convenience and long-term benefits.
Conclusions:
- Capillary islet autoantibody testing is a viable method for preschool T1D screening.
- Integrating T1D screening with routine vaccinations enhances convenience for families.
- Further optimization of capillary sample volume may be needed.
Objective:
Type 1 diabetes (T1D) screening programmes testing islet autoantibodies (IAbs) in childhood can reduce life-threatening diabetic ketoacidosis. General population screening is required to detect the majority of children with T1D, since in >85% there is no family history. Age 3-5 years has been proposed as an optimal age for a single screen approach.
Design:
Capillary samples were collected from children attending their preschool vaccination and analysed for IAbs to insulin, glutamic acid decarboxylase, islet antigen-2 and zinc transporter 8 using radiobinding/luciferase immunoprecipitation system assays. Acceptability was assessed using semistructured interviews and open-ended postcard questionnaires with parents.
Setting:
Two primary care practices in Oxfordshire, UK.
Main Outcome Measures:
The ability to collect capillary blood to test IAbs in children at the routine preschool vaccination (3.5-4 years).
Results:
Of 134 parents invited, 66 (49%) were recruited (median age 3.5 years (IQR 3.4-3.6), 26 (39.4%) male); 63 provided a sample (97% successfully), and one participant was identified with a single positive IAb. Parents (n=15 interviews, n=29 postcards) were uniformly positive about screening aligned to vaccination and stated they would have been less likely to take part had screening been a separate visit. Themes identified included preparedness for T1D and the long-term benefit outweighing short-term upset. The perceived volume of the capillary sample was a potential concern and needs optimising.
Conclusions:
Capillary IAb testing is a possible method to screen children for T1D. Aligning collection to the preschool vaccination visit can be convenient for families without the need for an additional visit.
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