More than 75% of individuals progress from asymptomatic stages to advanced stages of type 1 diabetes within five years, though this progression can occur even faster in children. This timeframe highlights the critical window for medical intervention, specifically the prescription of treatments aimed at slowing the destruction of pancreatic cells.
The Challenge of Early Diagnosis
Early diagnosis of type 1 diabetes remains a significant challenge in Brazil. In contrast, Europe and the United States already recommend blood tests to screen for the presence of autoantibodies – those capable of attacking the pancreas – in the general population at three distinct time points: between ages 2 and 4, between ages 6 and 8, and finally, between ages 10 and 15.
But, it’s important to note that autoantibodies can emerge later in life. The detection of these autoantibodies has revealed a concentration of diagnoses in childhood and adolescence, due to these being shorter phases of life, but people continue to be diagnosed in adulthood. “And because adulthood lasts longer, the absolute number of patients discovering the disease later in life ends up being higher,” explained a physician. “Previously, doctors often assumed that older patients had type 2 diabetes, the form more commonly associated with obesity, without considering type 1, which is autoimmune.”
Beyond the cost of testing for autoantibodies, the physician believes Brazil needs to prepare for the discovery of these cases. The Brazilian Society of Diabetes (SBD) plans to launch a pilot project in ten Brazilian cities, screening for autoantibodies across the population. “But positive cases will be referred to specialized centers in those regions,” she clarified, suggesting that early detection alone may not be enough without access to appropriate care.
Another project, led by the physician in partnership with the Fiocruz research institution, focuses on finding more affordable tests. This would craft the approval of medications like teplizumab even more impactful. The physician expressed optimism that the monoclonal antibody will usher in a modern era in diabetes treatment, paving the way for other therapies designed to protect the pancreas from autoimmune attacks.
