Pharmacists Can Provide Vital Information About Type 1 Diabetes Screening

In an interview with Pharmacy Times, Kristian Hurley, senior vice president of Programs, Advocacy, and Health Equity at Beyond Type 1, discussed the importance of screening for type 1 diabetes (T1D). Because T1D is not necessarily caused by genetics, educating patients about the signs and helping them get tested early is crucial. Hurley also discussed new survey research from Beyond Type 1 and commissioned by Sanofi.

Q: Why is screening so important for T1D?

Kristian Hurley: Well, as with anything, it's critically important that people are able to assess their risk and to learn early, right, if they're at risk for T1D in particular. So, with T1D, it develops in 3 stages, which most people don't know. Most people think that it just kind of occurs and there's no way to really to get out in front of it, but there are three stages of T1D. Most people get diagnosed in stage 3, which is often characterized by very high blood sugars [and] you're already needing to get on insulin right away. And there's a very high likelihood that you might have complications from getting diagnosed too late, and very often in an emergency setting. You know, very often this happens in the emergency room, and it's a crisis, right? And so, it's really important for people to get screened early because it does not have to be a crisis situation. Autoantibody screening can detect T1D in stages 1 and 2, and this is before any symptoms occur and before you're needing insulin, or before you are more likely to have any complications as a result of your diagnosis.

Q: What does screening for T1D look like for patients?

Hurley: Sure, so it's actually a simple blood test that you can take. You know, anyone can request an autoantibody test from their clinician or other places where you can access screening. But essentially, it's a blood test in which they are looking to detect diabetes-related autoantibodies in the body. So, you know, you go into your doctor's office and you request this blood test, and you can be screened for T1D. Beyond Type 1 does have a lot of resources to help people have this conversation with their clinician or with their [health care provider] in general, because oftentimes there's very low awareness, even within the clinical setting, that people can get an early test for T1D, particularly if there are no symptoms present. And so, we do have resources to help people now. If you struggle to get that test at your doctor's office, there are other online sources where they can even request a kit and get a test at home. They can use other sorts of for-profit clinics out in the world, Quest Diagnostics or Enable Biosciences, where you can access a kit that way. And there are also studies if you've got direct family members who have T1D, where you can go, like TRIALNET, or you can request that, and they'll send it to your home, and you can test that way.

Q: Many patients are unaware that T1D does not necessarily have a genetic component. How can this present challenges for screening, and how can these challenges be addressed?

Hurley: Well, it's actually a little more complicated than that, right? Because more than 80% of individuals who get diagnosed with T1D have absolutely no family history of T1D—which basically makes everyone at risk, right? And so, everyone needs to be thinking about this and assessing their own risk and getting out in front of it and getting that screening. However, if you do have an immediate family member—and I think this is where some of that confusion lives—if you do have an immediate family member, a parent, a sibling, a child with T1D, then you are 15 times as likely to develop T1D in that in that case. And so, it does increase your risk to get T1D. However, that's not the only story, right? Because again, as I said, over 80% of people who get diagnosed with T1D have no family history, so I think because of the statistic of the 15 times and an increased likelihood, that seems to be sort of the default thinking about T1D, that is that it only exists within families and that if you don't have a family member, then you're not at risk. But really, that's just not the case. And so, everyone really needs to be cognizant of this. And we're also seeing T1D increase in underserved communities and Black and brown populations. The age of diagnosis is growing; you know, it used to be like 13 years old was the average age of diagnosis. Now we're seeing people being diagnosed much more commonly in their 30s. And so, again, who is at risk has really grown and shifted and changed. And so, it's just really important to really redefine that risk setting for the general population and for our clinicians so that they can understand that and understand that critical need to make sure that we're talking about T1D with everyone, because really everyone is at risk.