Grant: DRA : Canada Graduate Research Scholarship - Doctoral Program (CGRS D)

What if we could detect (and possibly delay) Type 1 Diabetes (T1D) before it even starts? In T1D, the body's immune system mistakenly attacks the insulin-producing cells in the pancreas. Insulin is essential for controlling blood sugar (glycemia). People living with T1D need to take insulin injections daily for life and are at risk of serious health complications over time. For many, the first encounter with T1D is through a sudden and high glycemia or diabetic ketoacidosis (DKA), a life-threatening emergency often requiring a long and stressful hospital stay. This rough start can make glycemia harder to manage later on. We now know that the disease begins long before symptoms or even changes in glycemia. In this early "preclinical" phase, markers of the immune attack can already be detected in the blood. Studies show that early screening can reduce the risk of DKA, help preserve remaining pancreatic function and, with novel treatments, delay the onset of clinical T1D. Early screening could also allow for a gentler, more supported transition into life with T1D. Children, siblings, and parents of people with T1D (known as first-degree relatives) are 15x more likely to develop the disease than the general population. While international guidelines recommend early screening for T1D in first-degree relatives, no screening program exists in Canada. International studies show that people's participation in these programs can vary, which influences its potential health benefits. Therefore, we propose to investigate whether early screening would be feasible and acceptable in Quebec, starting with 1,000 first-degree relatives of people with T1D. We will offer them screening and follow anyone who tests positive for up to 3 years. We will monitor the uptake and collect clinical and biological data (e.g., glycemia) throughout the study. The knowledge gained will help clinicians and policymakers decide how best to introduce early screening and improve care for people at risk.