A major UK study has shown that screening children for Type 1 diabetes can identify the condition in its earliest stages, before symptoms appear, offering families time, choices… and hope.
Results from the first phase of the ELSA (Early Surveillance for Autoimmune Diabetes) study, co-funded by Breakthrough T1D and Diabetes UK, have been published in The Lancet. Led by researchers at the University of Birmingham, the ELSA study tests blood samples for autoantibodies, which are markers of Type 1 diabetes that can appear years before symptoms.
Children without these autoantibodies are unlikely to develop diabetes, while those with one autoantibody have a 15% chance of developing the condition within 10 years. Having two or more autoantibodies indicates the immune system has already started attacking the insulin-producing cells in the pancreas and it is almost certain these children will eventually need insulin therapy.
The ELSA study screened 17,283 children aged 3-13 years for Type 1 diabetes risk at the time of analysis and found that:
- 75 had one autoantibody
- 160 had two or more autoantibodies but did not yet require insulin therapy, indicating early-stage Type 1 diabetes.
- Seven were found to have undiagnosed Type 1 diabetes with all needing to start insulin immediately.
The families of children found to have early-stage Type 1 diabetes received tailored education and ongoing support to prepare for the eventual onset of diabetes symptoms, reducing the chances of needing emergency treatment. Children with one autoantibody also received ongoing support and monitoring.
Some families were also offered teplizumab, the first ever immunotherapy for Type 1 diabetes, which can delay the need for insulin by around three years in people in its early stages. Teplizumab was licensed by the Medicines and Healthcare products Regulatory Agency (MHRA) in the UK in August 2025 but is not yet available routinely on the NHS.
Building on this strong foundation, the second phase of the research, ELSA 2 has been launched, and will expand screening to all children in the UK aged 2-17 years, with a focus on 30,000 younger children and older teenagers.
ELSA 2 will also establish new NHS Early-Stage Type 1 Diabetes Clinics, providing families with clinical and psychological support, creating a clear pathway from screening to diagnosis, monitoring and treatment.
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