ELSA study finds childhood screening for type 1 diabetes could prevent thousands of emergencies

UK researchers have shown that screening children for type 1 diabetes can detect the condition early, preventing emergencies and enabling access to treatments that delay the need for insulin.

A major UK research programme has shown that screening children for type 1 diabetes (T1D) can detect the condition years before symptoms appear—dramatically reducing the risk of life-threatening emergencies at diagnosis and giving families time to prepare, plan, and access emerging treatments.

The findings come from the ELSA (Early Surveillance for Autoimmune diabetes) study, which has demonstrated that simple blood tests can identify early-stage T1D in children who otherwise appear healthy. Early detection allows for careful monitoring, education, and in some cases, access to therapies that can delay progression to insulin dependence.

Breakthrough T1D (formerly JDRF) reported that among the 17,283 children aged 3-13 years who were screened for type 1 diabetes risk at the time of analysis:  

• 75 had one autoantibody, a sign of increased future risk.  

• 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. 

Next steps: ELSA 2 launches

Building on this success, ELSA 2 is now being launched and will significantly expand the programme. The new phase aims to screen children aged 2–17 across the UK, with particular focus on younger children and older teenagers—groups at higher risk of presenting with diabetic ketoacidosis (DKA) at diagnosis.

Researchers plan to recruit 30,000 additional children and will establish new NHS Early-Stage Type 1 Diabetes Clinics, designed to support families from the moment of screening through diagnosis, monitoring, and treatment. These clinics will also offer psychological support, recognising the emotional impact of an early diagnosis.

A family perspective

Amy Norman, 44, from the West Midlands, was diagnosed with type 1 diabetes at 13. Through the ELSA study, her 11-year-old daughter Imogen was found to be in the early stages of T1D—before symptoms began. Imogen became only the second child in the UK to access teplizumab, an immunotherapy shown to slow progression to insulin-dependent diabetes.

“Knowing what’s coming—rather than being taken by surprise—has made an enormous difference,” Amy said. “Imogen was always going to develop type 1 diabetes, but through ELSA we’ve been able to slow the process and prepare. We’re not scared.”

Changing the future of type 1 diabetes

Lead researcher Parth Narendran, Professor of Diabetes Medicine at the University of Birmingham, said the study lays the groundwork for a national screening programme.

“Together with Diabetes UK, Breakthrough T1D and the National Institute for Health and Care Research, we are working towards a future where type 1 diabetes can be detected early and families are supported and treated to delay the need for insulin.”

Rachel Connor, Director of Research Partnerships at Breakthrough T1D, added: “This is about rewriting the story of type 1 diabetes. Instead of a devastating emergency, families gain time, choices, and hope—opening the door to treatments that can delay insulin by years.”

Why this matters

Around 1 in 3 children with newly diagnosed type 1 diabetes currently present in DKA as a medical emergency. Early screening could prevent thousands of hospital admissions, reduce trauma at diagnosis, and fundamentally change how T1D begins for future generations.

For more information or to take part, visit elsadiabetes.nhs.uk.

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The author of this blog has type 1 diabetes and uses a CGM on NHS prescription.