Islet Autoantibody Screening Throughout Australia Using In-Home Blood Spot Sampling: 2-Year Outcomes of Type1Screen

John M Wentworth^{1

2

3

4}, Anna B E Sing^{2

3}, Gaetano Naselli³, Dexing Huang³, Elizabeth Azidis-Yates¹, Batsho Mandlebe¹, James D Brown⁵, Kelly McGorm^{5

6}, Candice Hall^{1

4}, Leanne Redl¹, Renee Kludas¹, Aniruddh Haldar¹, Felicity Healy¹, Abbey Gilbert¹, Kelly Watson¹, Cherie Chiang^{1

2}, Jennifer J Couper^{5

6}, Tony Huynh^{7

8

9}, Elizabeth A Davis¹⁰, Maria E Craig^{11

12

13}, Fergus J Cameron¹⁴, Thomas W Kay⁴, Leonard C Harrison³, Peter G Colman¹

Affiliations

¹ Department of Diabetes and Endocrinology, Royal Melbourne Hospital, Parkville, Victoria, Australia.
² Department of Medicine, University of Melbourne, Parkville, Victoria, Australia.
³ Population Health and Immunity Division, Walter and Eliza Hall Institute, Parkville, Victoria, Australia.
⁴ St Vincent's Institute of Medical Research, Fitzroy, Victoria, Australia.
⁵ Faculty of Health and Medical Sciences, Adelaide Medical School, and Robinson Research Institute, University of Adelaide, Adelaide, South Australia, Australia.
⁶ Endocrinology and Diabetes Department, Women's and Children's Hospital, North Adelaide, South Australia, Australia.
⁷ Queensland Children's Hospital, South Brisbane, Queensland, Australia.
⁸ Children's Health Research Centre, Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia.
⁹ Department of Chemical Pathology, Mater Pathology, South Brisbane, Queensland, Australia.
¹⁰ Perth Children's Hospital, Nedlands, Western Australia, Australia.
¹¹ Children's Hospital Westmead, Westmead, New South Wales, Australia.
¹² Children's Hospital Westmead Clinical School, University of Sydney, Camperdown, Victoria, Australia.
¹³ Discipline of Paediatrics and Child Health, University of NSW, Kensington, New South Wales, Australia.
¹⁴ Royal Children's Hospital, North Melbourne, Victoria, Australia.

PMID: 39879258
DOI: 10.2337/dc24-2443

Islet Autoantibody Screening Throughout Australia Using In-Home Blood Spot Sampling: 2-Year Outcomes of Type1Screen

John M Wentworth et al. Diabetes Care. 2025.

. 2025 Apr 1;48(4):556-563.

doi: 10.2337/dc24-2443.

Authors

Affiliations

¹ Department of Diabetes and Endocrinology, Royal Melbourne Hospital, Parkville, Victoria, Australia.
² Department of Medicine, University of Melbourne, Parkville, Victoria, Australia.
³ Population Health and Immunity Division, Walter and Eliza Hall Institute, Parkville, Victoria, Australia.
⁴ St Vincent's Institute of Medical Research, Fitzroy, Victoria, Australia.
⁵ Faculty of Health and Medical Sciences, Adelaide Medical School, and Robinson Research Institute, University of Adelaide, Adelaide, South Australia, Australia.
⁶ Endocrinology and Diabetes Department, Women's and Children's Hospital, North Adelaide, South Australia, Australia.
⁷ Queensland Children's Hospital, South Brisbane, Queensland, Australia.
⁸ Children's Health Research Centre, Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia.
⁹ Department of Chemical Pathology, Mater Pathology, South Brisbane, Queensland, Australia.
¹⁰ Perth Children's Hospital, Nedlands, Western Australia, Australia.
¹¹ Children's Hospital Westmead, Westmead, New South Wales, Australia.
¹² Children's Hospital Westmead Clinical School, University of Sydney, Camperdown, Victoria, Australia.
¹³ Discipline of Paediatrics and Child Health, University of NSW, Kensington, New South Wales, Australia.
¹⁴ Royal Children's Hospital, North Melbourne, Victoria, Australia.

PMID: 39879258
DOI: 10.2337/dc24-2443

Abstract

Objective: Type1Screen offers islet autoantibody testing to Australians with a family history of type 1 diabetes (T1D) with the dual aims of preventing diabetic ketoacidosis (DKA) and enabling use of disease-modifying therapy. We describe screening and monitoring outcomes 2 years after implementing in-home capillary blood spot sampling.

Research design and methods: Data from 2,064 participants who registered between July 2022 and June 2024 were analyzed: 1,507 and 557 chose blood spot and venipuncture screening respectively. We compared baseline characteristics and outcomes for 1,243 participants (967 blood spot and 276 venipuncture) whose samples were tested by June 2024.

Results: One blood spot and five venous participants reported unsuccessful sample collections. The median (quartile 1, quartile 3) age of blood spot registrants was lower (12.1 [7.1, 27.1] vs. 17.2 [9, 38.4] years; P < 0.0001), and a higher proportion lived in regional Australia (39% vs. 29%; P = 0.0037). Among 72 participants (5.9%) with a positive screening test, 5 screened by blood spot and 2 by venipuncture had no autoantibodies on confirmatory testing. Blood spot screening identified the expected 2.1% prevalence of multiple autoantibodies and a 2.5% prevalence of a single autoantibody compared with 1.5% and 4.1%, respectively, for venipuncture screening. Clinical diabetes developed in 12 participants. All had screened positive and none had DKA.

Conclusions: Type1Screen has national reach. In-home blood spot screening is feasible, particularly for younger participants living regionally, and identifies the expected prevalence of preclinical T1D. The lower cost, increased convenience, and greater reach of blood spot screening could help meet increasing demand for early T1D diagnosis.

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Islet Autoantibody Screening Throughout Australia Using In-Home Blood Spot Sampling: 2-Year Outcomes of Type1Screen

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Islet Autoantibody Screening Throughout Australia Using In-Home Blood Spot Sampling: 2-Year Outcomes of Type1Screen

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