Focus of research
Type 1 diabetes is the most common chronic metabolic disease in children and adolescents. The pathogenesis of diabetes mellitus is characterized by loss of insulin-producing beta cells of the pancreatic islets of Langerhans, which in type 1 diabetes is caused by islet cell autoimmunity. We investigated how autoimmunity develops during the course of the disease in children and looked at the target epitopes of beta cell antigens and the factors that predispose children to develop autoimmunity. We were able to show that beta cell autoimmunity already starts in early childhood, with a peak around the 1st or 2nd birthday which is often long before clinical symptoms appear. During this time, many new environmental influences take place, and we have shown that the immune system is also susceptible to activation at this age. Our studies have provided evidence that autoimmunity is a precursor to clinical disease. The aim of our research is to develop and improve early detection of type 1 diabetes in order to identify children before the onset of the disease and to prevent or delay the disease through prevention and intervention studies.
Studies on type 1 diabetes screening and prevention in newborns
Genetic predisposition plays an important role in the development of type 1 diabetes. Together with the Helmholtz Zentrum München, we have developed a genetic score to identify newborns with an increased risk of developing the disease as part of the Freder1k study. This test enables affected families with children to take part in a prevention study in order to prevent or delay the onset of the disease. Numerous (environmental) factors can contribute to the pathogenesis of type 1 diabetes. In our prevention studies, various approaches were chosen to prevent the development of the disease.
POInT (Primary Oral Insulin Trial): The POInT trial investigated whether daily administration of oral insulin in children with increased genetic type 1 diabetes risk can prevent the development of beta-cell autoimmunity by training the immune system (Ziegler et al, 2025, Efficacy of once-daily high-dose oral insulin immunotherapy in children genetically at-risk for type 1 diabetes: a European randomized, placebo-controlled primary prevention trial. THE LANCET. DOI: 10.1016/S0140-6736(25)01726-X.)
SINT1A (Supplementation with B. Infantis for Mitigation of Type 1 Diabetes Autoimmunity): The SINT1A study is investigating whether the administration of the probiotic B. infantis can prevent the development of type 1 diabetes in children with an increased risk of type 1 diabetes through a positive influence on the immune system.
AVAnT1A (Anti-Viral Action Against Type 1 Diabetes Autoimmunity): The AVAnT1A study is investigating whether SARS-CoV vaccination of children with an increased genetic type 1 diabetes risk can protect against the development of the autoimmune reaction and which other early childhood viral diseases play a role in the development of type 1 diabetes.
You can find more information about our clinical studies and our study center on our website www.typ1diabetes-studien-sachsen.de
Study on the early detection of type 1 diabetes at an early stage
Long before a child shows clinical symptoms of type 1 diabetes, autoantibodies against the islet cells of the pancreas are detectable in the blood. In the Fr1da study, children can be tested for the presence of these autoantibodies in order to avoid dangerous metabolic imbalances at the onset of the clinical disease. Children with this so-called type 1 diabetes early stage are offered a training and follow-up program to monitor the development of type 1 diabetes and, if necessary, to participate in therapies or intervention studies to delay the progression of the disease. You can find more information at www.fr1da.de.
The Fr1da study is part of the EDENT1FI consortium (European action for the diagnosis of early non-clinical type 1 diabetes for disease interception), a consortium of 27 partners in 13 countries from academia, industry and patient organizations, which aims to stop type 1 diabetes in the preclinical phase.