The University of Bristol spearheads a groundbreaking initiative to identify and track adults at high risk of developing type 1 diabetes. The Type 1 Diabetes Risk in Adults (T1DRA) study, inaugurated on World Diabetes Day (14th November 2023), is the first of its kind to offer this kind of risk assessment to the general adult population in a research setting. About Type 1 Diabetes Type 1 diabetes is a lifelong autoimmune condition, affecting up to 400,000 people in the UK. Essentially, the immune system aggressively targets insulin-producing cells in the pancreas, leading to high, unsafe blood sugar levels. Although over half of diagnoses occur in adults, the disease's development is primarily studied in children, with limited understanding of adult-onset type 1 diabetes. T1DRA Study Target Audience The T1DRA research team helmed by Professor Kathleen Gillespie plans to recruit 20,000 UK adults, aged between 18 and 70, without close family ties to type 1 diabetes, for this study. This group constitutes about 90% of the people diagnosed with the condition. Carrying Out the T1DRA Study The T1DRA study will send out test kits for a simple finger prick blood test to volunteers. These samples will be examined for markers of type 1 diabetes, namely, islet autoantibodiesproteins that the immune system deploys to mark insulin-producing cells for destruction. Islet autoantibodies often present in the blood several years or even decades before any symptoms manifest, therefore can indicate an increased risk of developing type 1 diabetes. Benefits to High-Risk Participants Those classified as high-risk will be given education about type 1 diabetes, its ongoing management and offered participation in trials for new type 1 therapies. The T1DRA team will monitor high-risk participants to understand the development rate of their condition, what leads to a clinical diagnosis, the associated genetic and environmental factors, and how symptoms progress. Emerging Therapies for Type 1 Diabetes While insulin therapy remains the standard treatment for managing type 1 diabetes, several new immunotherapies are poised to either prevent or delay onset of the disease. A noteworthy contender is teplizumab, which successfully postponed a diagnosis of type 1 diabetes by approximately three years during trials in the US. The medication is currently under review for approval within the UK, with numerous other immunotherapies for high-risk individuals being evaluated through clinical trials. Complementary Child Study The adult-oriented T1DRA study complements an earlier launched child-centered ELSA (EarLy Surveillance for Autoimmune diabetes) study, an ongoing nationwide type 1 screening trial for children aged 3-13 years. Implications of These Studies Both the T1DRA and ELSA research will significantly contribute to understanding type 1 diabetes's onset in adults and children. It also offers high-risk individuals early monitoring and potential access to innovative prevention methods, thereby reshaping the narrative around diabetes care and management. Related Information For more information about T1DRA or to sign up, visit: t1dra.bristol.ac.uk. For more information about the ELSA child screening trial, visit: elsadiabetes.nhs.uk.