(WXYZ) — November is Diabetes Awareness Month; it’s a disease that affects millions of people across the United States – both with type one and type two.
Type one diabetes (T1D) is an autoimmune disease. Breakthrough T1D, formerly known as JDRF, reports that around 9 million people around the world live with T1D. It’s a disease that can appear at any moment.
However, growing research is helping scientists and doctors learn more about the disease. One way they’re gathering that information is through early screening.
Last year, Sanofi, a healthcare company that focuses on diabetes care and research, launched “The 1 Pledge” aimed at encouraging screening.
Dr. Jessica Dunne, the autoimmune diabetes medical director for Sanofi, said that in early screening, they test for four islet autoantibodies. Because T1D is an autoimmune disease, the immune system attacks the beta cells of the pancreas, and the beta cells are what produce insulin.
“It was discovered these islet cell autoantibodies were actually very predictive of disease progression,” Dunne said. “What we do know is that they are a marker of impending disease.”
According to Dunne, they scan for four different autoantibodies. She said that research has shown if you develop two or more of the islet autoantibodies, you’re at risk for T1D.
In fact, according to Dunne, your five-year risk of developing T1D is 44%; your 10-year risk is 70%; and your lifetime risk almost reaches 100%.
Early screening is also key for reducing diabetic ketoacidosis (DKA) at the time of diagnosis. According to Dunne, 40%-60% of people get diagnosed in DKA, which has severe outcomes.
According to the CDC, DKA develops when your body doesn’t have enough insulin to allow blood sugar into your cells for use as energy. DKA is a serious condition that can lead to a diabetic coma or even death.
“We know through these students where you can screen and follow them up through time before they get diagnosed, that that number gets reduced down to 3%-5% in some cases,” Dunne said.
Watch more from our interview with Dr. Jessica Dunne in the video below
ESPN NFL Insider Adam Schefter has also partnered with Sanofi to encourage early screening. His wife has been a type one diabetic for more than two decades. He said he’s been screened and so have their kids.
“The more information you have, the better off you are. So why would you not screen for something like this if you were given the opportunity to do it in advance,” Schefter said.
Schefter said that while he knows it can be scary to get tested and cause worry while awaiting results, screening is better than not knowing.
“Early detection is, we believe, critically important and it helps give you the knowledge and education you need in advance,” Schefter said. “It just makes a whole lot of sense and people are ahead of the game if they do that.”
Watch more from our interview with Adam Schefter in the video below
Another reason for encouraging screening is to help fight misdiagnosis. T1D is often thought of as diabetes you’re born with or you developed as a kid, but according to Dunne, the median age of T1D diagnosis is around the age of 25, and 50-60% of people get diagnosed as an adult.
On a personal level, my wife, Carol, was diagnosed with T1D at the age of 27 in January 2023. However, she was misdiagnosed for more than a year.
During a Beyond Type 1 event in April as part of the NFL Draft weekend, I was screened for T1D. Her brother has also been screened.
“Just understanding and being able to treat type one diabetes appropriately starts with the correct diagnosis,” Dunne said.
So, who should get screened? It’s actually very complex, according to Dunne. Family members have a 15 times greater risk of developing type one diabetes. However, 90% of people who get diagnosed with type one diabetes don’t have a family member who has been diagnosed.
“That sort of begs the question in terms of, how do we screen in the general population to catch the majority of people with type one diabetes?” Dunne said.
“If you have a history of family history and or if you have either type one diabetes or another autoimmune condition or if you are just glycemic and maybe don't fit what may be considered a profile for somebody with type two diabetes, we would encourage you to go talk to your physician to get screened for type one diabetes,” Dunne added. “That's the starting point. But ultimately, we would really like to march toward a place where we're screening the population for type one diabetes.”
TrialNet allows screening for these groups of people:
- Between the ages of 2 and 45 who have a parent, brother/sister or child with T1D
- Between the ages of 2 and 20 with an aunt/uncle, cousin, grandparent, niece/nephew or half-bother/sister with T1D
- Have not been diagnosed
Dunne also said that people often think that a T1D diagnosis is a cliff, but really, there are actually stages to the diagnosis, and screening may help catch the diagnosis early.
“What we really know now is that there's this long period ahead of a diagnosis that can last for four years in some individuals where there's actually active disease, but it's subclinical,” Dunne said. “Which means that we don't actually have an appreciation that there is a disease because people who appear healthy on the outside, you know, they don't have any symptoms.”
According to Breakthrough T1D and Sanofi, stage one is when the beta cell attack begins but blood sugars are in normal range and there are no signs or symptoms. Stage two is when the autoantibodies are present, but blood sugar levels are abnormal. Stage three is when your body is no longer able to make enough or any insulin, and visible signs and symptoms appear. That’s usually when T1D is diagnosed.
Be sure to look out for the signs of type one diabetes. They include:
- Frequent urination
- Extreme thirst
- Dry mouth
- Fatigue and weakness
- Increase appetite even though you are eating
- Unexplained weight loss
- Blurry vision
Dunne said researchers are still working to understand when adults develop the islet autoantibodies, which makes it a little more challenging to screen.
“My goal is in the next five or 10 years, we’re doing pediatric screening in the general population. You know, as part of our standard of care. I think we’re at the point where we’ve got the tools to do it,” Dunne said.
