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General Population Level Estimation for Type 1 Diabetes Risk in Children During Routine Care Delivery

Recruiting
Conditions
Type 1 Diabetes
Celiac Disease
Interventions
Diagnostic Test: Sera and whole blood sampling
Diagnostic Test: Differential Gene Expression (DGE)
Registration Number
NCT04477928
Lead Sponsor
Sanford Health
Brief Summary

In partnership with Helmsley Charitable Trust, the Sanford PLEDGE Study is a large-scale, observational, feasibility study of general population screening for T1D and celiac autoantibodies. Screening is incorporated into routine health care visits within an integrated health system.

Detailed Description

Most children with type 1 diabetes (T1D) do not have a family member with diabetes and often are not diagnosed until the child is very sick. Research suggests that screening and identifying children at risk for T1D autoantibodies can prevent serious illness at the time of diagnosis and improve long-term health outcomes.

The investigators will screen children, ages 0-5.99 or 9-16 years for blood markers related to T1D and celiac disease during routine healthcare delivery at birth, 1, 2 and 5 years, or once between 9 and 16 years of age. Children with confirmed autoantibodies will be offered participation in other monitoring or prevention trials (T1D), or referred to clinical care (celiac).

Recruitment & Eligibility

Status
RECRUITING
Sex
All
Target Recruitment
33000
Inclusion Criteria
  • Newborn Entry: Viable, term infants, defined as 36 weeks gestation by either dates or ultrasound who are born to pregnant women, 18 years or older, who are willing and able to provide informed consent (IC) prior to the onset of active labor. Who are born at a Sanford Health Hospital and plan to have routine well-child care at a Sanford Clinic
  • Pediatric Entry: Children less than 6 years of age who receive their routine care at a Sanford facility and whose parents are able to provide IC.
  • Adolescent Entry: Children, ages 9-16 years old, who receive their routine care at a Sanford facility and whose parents are able to provide IC.
  • Siblings of children known to have T1D-relevant antibodies; ages 6 to 17 years old who receive care at a Sanford clinic
  • Have an active MyChart account (with proxy access).
Exclusion Criteria
  • Subject is in the opinion of the investigator, unable to comply with the requirements of the study protocol.
  • Children known to have T1D

Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Arm && Interventions
GroupInterventionDescription
Study GroupSera and whole blood samplingChildren receiving routine care at a Sanford facility
Study GroupDifferential Gene Expression (DGE)Children receiving routine care at a Sanford facility
Primary Outcome Measures
NameTimeMethod
Demonstrated feasibility of large-scale population screening, as evidenced by:By year 10 of the study

1. The percentage of parent(s) that viewed the MyChart study information who went on to complete the MyChart informed consent, HIPAA and questionnaires.

2. Of those who consented to be in the study, the percentage who went on to obtain the initial sample.

3. Of the total samples collected, percentage that were valid and results received.

4. The percentage of subjects who complete their \~60 month visit by their 6th birthday.

Secondary Outcome Measures
NameTimeMethod
Percentage of T1D seropositive subjects who enroll in another T1D monitoring or prevention study.By year 10 of study
Seroconversion rates for T1D-relevant and celiac autoantibodiesBy year 10 of study
Number and type of procedure-related adverse eventsBy year 10 of study
Assessment of costs associated with implementation of study compared to potential impacts on cost and quality of life.By year 10 of study
Proportion of participants developing overt hyperglycemia consistent with T1D (Stage 3), who present in diabetic ketoacidosis (DKA)By year 10 of study
Percentage of celiac seropositive subjects referred on to GI or primary careBy year 10 of study
The percentage of celiac seropositive subjects who were evaluated in clinical settingBy year 10 of study
The rate of development of overt hyperglycemia consistent with T1D (Stage 3).By year 10 of study

Trial Locations

Locations (4)

Sanford Bismarck Region Clinics

🇺🇸

Bismarck, North Dakota, United States

Sanford Bemidji Region Clinics

🇺🇸

Bemidji, Minnesota, United States

Sanford Sioux Falls Region Clinics

🇺🇸

Sioux Falls, South Dakota, United States

Sanford Fargo Region Clinics

🇺🇸

Fargo, North Dakota, United States

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