If one of your children has type 1 diabetes, it's natural to wonder if another child will develop it somewhere along the way. Thanks to a nationwide program called Pathway to Prevention, you can learn if your child is at a higher than normal risk. If he is, you even may be eligible to enroll him in one of the clinical trials underway to see if type 1 diabetes can be delayed or prevented.

In the screening, aimed at identifying siblings as well as close relatives of children with type 1 diabetes, researchers look for certain markers in the blood that suggest the future development of the disorder. So far, well over 100,000 individuals have been screened. The good news is that only 4 to 5 percent of all the individuals who are screened will actually turn out to have the markers that indicate risk for developing type 1 diabetes.

Pros and Cons of Screening for Type 1 Diabetes

While it makes sense from the standpoint of helping scientists learn more about the disease, screening is important for other reasons, too. "There is more reason to screen than just because you want to help others down the line," says Ellen M. Greenberg, MS, lead coordinator of the Type 1 Diabetes Research Group at Naomi Berrie Diabetes Center Columbia University in New York City. "Right now, there are three prevention trials underway.  If your child qualifies, there may be a spot for her in one of trials now underway."

However, it is too soon to tell if any of these trials will be effective, Greenberg says.

Learning that your child may some day get type 1 diabetes is difficult. "There is an emotional component to finding out that your child is at risk for developing a disease," Greenberg says. "But there is power in knowledge. There is also something you can do about it."

One trial, which is open to children as young as three years old, is examining whether oral insulin may be effective at delaying the onset of type 1 diabetes. Other trials, also enrolling children, involve taking a medication.

An earlier trial, which involved giving at-risk children insulin even before they developed full-blown diabetes, didn't have promising results, says Spyros Mezitis, MD, PhD, an endocrinologist at Lenox Hill Hospital in New York City. "The thinking was that by giving the insulin, it wouldn't tire out the pancreas," he explains. "But eventually the kids developed type 1 diabetes."

The National Institutes of Health TrialNet Pathway to Prevention Research Study is open to anyone between the ages of 1 and 45 with a brother, sister, child or parent with type 1 diabetes. If you are 20 or under and have a cousin, aunt, uncle, niece, nephew, or half sibling with type 1 diabetes, you also are eligible to participate in the screening. Major medical centers across the country are participating in the trials.

Ellen M. Greenburg, MS, reviewed this article.




"When does Type 1 diabetes begin to develop? Research reveals how to identify those at highest risk." 21 June 2013. American Diabetes Association.

"Natural history study of the development of Type 1 diabetes." Type 1 diabetes TrialNet.