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Feasibility of screening for T1D and celiac disease in a pediatric clinic setting
Author(s) -
Gesualdo Patricia D,
Bautista Kimberly A,
Waugh Kathleen C,
Yu Liping,
Norris Jill M,
Rewers Marian J,
Baxter Judith
Publication year - 2016
Publication title -
pediatric diabetes
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.678
H-Index - 75
eISSN - 1399-5448
pISSN - 1399-543X
DOI - 10.1111/pedi.12301
Subject(s) - medicine , autoantibody , type 1 diabetes , population , autoimmunity , disease , tissue transglutaminase , immunology , coeliac disease , diabetes mellitus , pediatrics , antibody , endocrinology , environmental health , biochemistry , chemistry , enzyme
Objective Type 1 diabetes ( T1D ) or celiac disease ( CD ) develops in at least 2% of the general population. Early detection of disease‐specific autoimmunity and subsequent monitoring would be possible if screening tests were more widely available. Currently, screening for islet autoimmunity is available only in a research setting, and CD ‐specific autoimmunity screening is limited to those in high‐risk groups. This study assessed the feasibility of incorporating T1D and CD autoantibody screening into a pediatric practice. Methods Patient engagement strategies, blood collection preference, blood sample volume, rate of autoantibody detection in the general population, and parental satisfaction were assessed. Over 5 weeks, research staff recruited 200 patients, aged 2–6 yr from two pediatric practices in the Denver area to be screened for islet autoantibodies (IAs) and the transglutaminase antibody. Results Of the 765 parents approached, 200 (26%) completed the same‐day screening. Of the 565 subjects who did not complete the screening, 345 expressed interest, but were unable to make a participation decision. A finger stick, compared with a venous draw, was the preferred method of sample collection. Both methods yielded sufficient blood volume for autoantibody determination. IAs or the transglutaminase antibody were detected in 11 subjects. Parents expressed satisfaction with all aspects of participation. Conclusions The results of this study suggest that it is feasible to conduct this type of screening in a pediatric clinic. Such screening could lead to increased disease awareness and the possible benefits that can result from early detection.