Ten new cases of type 1 diabetes are diagnosed every day in Australia, three of which are diagnosed too late, resulting in traumatic diabetic ketoacidosis requiring intensive care. However, formal recognition of two early presymptomatic stages allows for early identification and an opportunity to prevent, or at least delay type 1 diabetes. Launching in early 2022, a new pilot study will assess the feasibility, acceptability and cost-effectiveness of a routine national screening program for type 1 diabetes in children.
Type 1 diabetes results from immune-mediated destruction of insulin-producing pancreatic beta cells. Over 125,000 Australians have type 1 diabetes, with over 3,700 diagnosed in 2020 (10 new cases per day).1 It is frequently diagnosed in children and young adults, with the peak incidence between 10 and 14 years of age.2 Management is complex and burdensome, both for the individual and their family, requiring lifelong insulin therapy to maintain blood glucose levels within the narrow limits of normoglycaemia and to avoid acute, hypo- and hyperglycaemia. Suboptimal glycaemic control is closely associated with serious acute and chronic diabetes complications, such as severe hypoglycaemia, recurrent diabetic ketoacidosis (DKA), diabetic eye disease (retinopathy, macular oedema, blindness), nephropathy/chronic kidney disease, neuropathy (which can lead to amputation), reduced lifespan and significant psychological morbidity.