New Canadian Initiative to Screen Relatives for Type 1 Diabetes Risk
MONTREAL — The Montreal Clinical Research Institute (IRCM) has launched a new national screening initiative to identify individuals at risk of developing type 1 diabetes, specifically focusing on relatives of those already diagnosed with the condition.1 This project, unique in Canada, aims to recruit 1,000 participants with a family history of type 1 diabetes to enable earlier detection, potentially even before symptoms appear.
Rising Incidence of Adult-Onset Type 1 Diabetes
Dr. Rémi Rabasa-Lhoret, principal investigator of the project at the IRCM, highlighted a significant increase in the incidence of type 1 diabetes in adults over the past 50 years.1 This trend presents diagnostic challenges, as primary care physicians may not readily consider type 1 diabetes in adult patients, potentially leading to misdiagnosis as type 2 diabetes and inappropriate treatment.
“It seems totally illusory to me to base ourselves on the first line,” said Doctor Rabasa-Lhoret. “In the list of things that a primary care physician has to do, (screening for type 1 diabetes) is going to be priority number 25.”1
The Federate Can Initiative: A Collaborative Approach
The Federate Can initiative brings together doctors, nurses and researchers to promote awareness and accessibility to early detection programs.1 The project’s website states its objective is to “evaluate the feasibility and adherence to an early detection program for type 1 diabetes in people and the monitoring of progression in adult first-degree relatives (mother, father, brother, sister, child) of people living with type 1 diabetes in Quebec.”1
Understanding Type 1 Diabetes and Family Risk
Type 1 diabetes is an autoimmune disease characterized by the destruction of insulin-producing cells in the pancreas, leading to an inability to regulate blood sugar levels.1 It accounts for approximately one in ten cases of diabetes.1 Individuals with a first-degree family member (parent, sibling, or child) with type 1 diabetes face a significantly elevated risk of developing the disease themselves.
- Risk with a mother affected: 4%1
- Risk with a brother or sister affected: 7%1
- Risk with a father affected: 9%1
This compares to an average lifetime risk of around 0.4% for individuals without a family history.1
Benefits of Early Detection
While early detection will often reveal a low risk of developing type 1 diabetes, identifying those at high risk can offer significant benefits.1 These include preventing serious complications like diabetic ketoacidosis, avoiding hospitalization, and facilitating a gradual, well-managed transition to insulin therapy.1
“We find antibodies in the blood, markers that something is being destroyed,” explained Dr. Rabasa-Lhoret. “And research has remarkably clearly demonstrated that as soon as you have two of these four positive markers, the risk over the rest of your life of developing type 1 diabetes is almost 100%.”1
Early detection, when effective, can similarly reduce the risk of hospitalization and improve quality of life by preserving some remaining insulin-producing cells for a longer period.1 Better blood sugar control, in turn, minimizes the risk of long-term damage to organs like the eyes and heart.1
Project Details and Eligibility
The screening, offered free of charge as part of the project, involves a simple blood test.1 Currently, the initiative is open to individuals aged 18 to 65 who have never been diagnosed with type 1 diabetes but have a first-degree relative living with the condition.1
“We want 1000 people in order to have good learning,” concluded Doctor Rabasa-Lhoret. “It is a first step intended after that to be gradually extended, ideally to the general population.”1