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Screening finds children at high risk for type 1 diabetes and celiac disease

In Skåne, newborn babies can be screened for type 1 diabetes and celiac disease (gluten intolerance). More than expected have been found to have an increased risk of developing these diseases, and about thirty children have already been recruited for research studies aimed at lowering this risk.

The oral insulin is mixed with the food.
The oral insulin is mixed with the food. Photo: Johan Bävman

Large-scale screening of newborn children in Skåne started in the summer of 2018 and will last until 2023. The screening is part of a European initiative, GPPAD (Global Platform for the Prevention of Autoimmune Diabetes) and is implemented, in addition to Skåne, in six other sites in Germany, Poland, Belgium and the UK. Over 70,000 infants have now been screened in the European countries and over 200 children are included in one of the two  prevention studies.

1,600 children screened in Skåne

Among the 1,600 children so far screened in Skåne, 2.8 percent of the children have an increased risk for type 1 diabetes and 2.3 percent carry the highest elevated hereditary risk of suffering from celiac disease. The majority of these children are now participating in one of the preventive studies POInT (Primary Oral Insulin Training) or PreCiSe (Prevention of Celiac Disease in Skåne). Children with hereditary risk for type 1 diabetes during the first three years of life are treated with oral insulin; so-called ‘immune tolerance training’. Children with the highest hereditary risk of celiac disease are treated during the first three years with probiotics or gluten-free diet. The studies are run by Skåne University Hospital in collaboration with Lund University.

Informed by midwives

"Parents have been informed during the pregnancy and given their consent to the screening, and almost everyone who is told that their children have the increased risk chooses participate in a prevention study", says Jeanette Åkerström Kördel, who coordinates the screening.

Much of the work is done by midwives out at the midwifery clinics and the delivery departments in Region Skåne.

These midwives inform parents (or expectant parents) about the study and take the blood tests that form the basis of the screening so they make a huge effort to really find these children! Thanks to the efforts of these activities, we can early identify small children who are at risk of suffering from type 1 diabetes or celiac disease.

 

About the studies

POInT:

In POInT, we are testing whether it is possible to get the immune system used to insulin by giving the child insulin via the food, much like inducing immune tolerance in allergies by regular exposure to small doses of the substance that one is allergic to. Half of the children in the study will receive oral insulin and the other half will get placebo.

PreSiCe:

The purpose of Prevention Celiac disease in the Skåne (PreCiSe) study is to study whether a gluten-free diet during the child's first three years of life reduces the risk of developing celiac disease compared to eating a normal diet but with supplementation of probiotics and placebo respectively. The study aims to include 600 participants in three different groups.

More information: www.gppad.org/sv

Contact

Jeanette Åkerström Kördel, coordinator for the screening: 040–391133

Helena Elding Larsson, pediatrician Skåne's university hospital and researcher at Lund University responsible for POInT, the study of type 1 diabetes: helena [dot] elding_larsson [at] med [dot] lu [dot] se

Daniel Agardh: pediatrician Skåne's university hospital and researcher at Lund University responsible for PreCiSe, the study of celiac disease: daniel [dot] agardh [at] med [dot] lu [dot] se

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Lund University Diabetes Centre, CRC, SUS Malmö, Jan Waldenströms gata 35, House 91:12. SE-214 28 Malmö. Telephone: +46 40 39 10 00