Funding so all infants are offered Type 1 Diabetes Testing in routine care

Fund mandatory offer of testing for Type 1 Diabetes in babies, toddlers, and young children as a routine part of medical assessments at the point of care.

We believe that lives could be saved by doing this. Too many children are misdiagnosed, and this can tragically lead to loss of life.

Type 1 diabetes is diagnosed with a blood test that checks blood glucose (sugar) levels. It is the responsibility of the National Institute for Health and Care Excellence (NICE) to provide guidance and quality standards on the treatment and care of diabetes in England. NICE NG18 guideline for type 1 and 2 diabetes provides clinical guidelines for the diagnosis, treatment and care of children and young people. It states that clinicians should be aware of the signs of type 1 diabetes in children and young people, including:

• hyperglycaemia • polyuria (passing urine more often) • polydipsia (excess thirst) • weight loss • excessive tiredness.

NG18 also recommends that children and young people with suspected type 1 diabetes are referred immediately (on the same day) to a multidisciplinary paediatric diabetes team with the competencies needed to confirm diagnosis and provide immediate care.

NHS England is not aware of there being any evidence for the feasibility and effectiveness of the mandatory offer of testing for type 1 diabetes in babies, toddlers, and young children as a routine part of medical assessments.

NHS England works closely with research charity Diabetes UK which has worked to raise public and health care professional awareness of the common symptoms of type 1 diabetes, known as the 4Ts: Toilet, Thirsty, Tired and Thinner. Further information of this campaign can be found here:https://www.diabetes.org.uk/about-diabetes/type-1-diabetes/symptoms

Early identification of type 1 diabetes through screening for antibodies prior to the onset of physical symptoms can provide clinical benefits, including helping to prevent diagnosis at the point of diabetic keto-acidosis (DKA). However, there is not currently a national screening programme in England.

The UK National Screening Committee advises the NHS on screening programmes and, in 2019 concluded that more research and evidence for the benefits of screening for autoimmune type 1 diabetes was required.

A National Institute for Healthcare Research-funded study called ELSA (EarLy Surveillance for Autoimmune diabetes) is currently underway in England exploring the feasibility and benefits of screening in children aged 3 to 13. NHS England is working closely with researchers and leading experts in this field to ensure that emerging evidence is considered in the development of future national guidance and is reviewed ahead of further decisions on the availability of screening.

Department of Health and Social Care