Type 1 diabetes (T1D) describes a disorder that presents when the pancreas cannot produce insulin, a hormone needed to regulate blood sugar levels. T1D is an autoimmune disease that develops because the patient’s immune cells destroy the cells in the pancreas that produce insulin. The CDC estimates that about 1.6 million Americans and over 200,000 adolescents (under 20) have been diagnosed with T1D.
Delayed diagnosis of T1D is often associated with a severe complication called diabetic ketoacidosis (DKA), which arises when the insulin is so deficient that the body's cells can’t obtain enough sugar to generate biological energy. DKA leads the body to break down fat to create the fuel needed to survive. Keytones, acids produced during this process, can build up, causing rapid breathing, nausea, fatigue, and aches. DKA presence at the time of T1D diagnosis is associated with poor outcomes. Thus, early diagnosis of T1D would reduce DKA occurrence and improve long-term prognosis.
Comprehensive screening for pre-symptomatic T1D could significantly reduce cases of DKA in undiagnosed T1D patients but implementing such practices would be costly. However, data accessing potential costs of a screening program for young children are limited. A new study published in Diabetes Care has generated estimates on universal screening costs to address this need.
The published data emerged from the Fr1da study, the most extensive public health screening program for pre-symptomatic T1D. Initiated in Germany, the Fr1da study had enrolled over 90,000 participants at the time of analysis. The study provides for all children up to six years of age the option of a blood test to identify T1D associated proteins. Doctors offer the children testing positive follow-up monitoring, additional testing, and education.
The study estimated that universal screening for pre-symptomatic T1D in young children would cost about 22 euros (~ USD 25) per child. Follow-up testing and educational programming were estimated at 7,000 euros (~ USD 8,000) per child testing positive for pre-symptomatic T1D.
While costs may differ from country to country, this study provides essential information that could be used to design universal T1D screening programs. These findings can aid in implementing cost-effective strategies to prevent DKA and employ early intervention for children with T1D.
Sources: Diabetes Care, Pediatr Diabetes, Diabetes Care