Diabetes and celiac disease in children: the pilot phase is good, now the national screening takes off

Screening children for type 1 diabetes and celiac disease works and is able to intercept possible cases early. This is what the first results of the D1CeScreen project coordinated by the Ministry of Health and the Istituto Superiore di Sanità affirm, presented at the ISS headquarters in the presence of the Vice President of the Chamber Giorgio Mulè, promoter of law 130/2023 that established the national screening. “This event – ​​explained Mulè – gives a sense of the success of a work that has united the scientific community, patients, and the administration. Today, a fundamental stage officially closes, that is, understanding what to put in the screening 'toolbox'. At the same time, we have worked to build the national screen that will start at the end of 2025 or at the beginning of 2026”.

The results obtained in the four pilot regions (Campania, Lombardy, Marche, Sardinia) showed a positivity rate for the screening test for type 1 diabetes (T1D) of 0.97%, while for celiac disease (CD) the positivity rate for the screening test for the detection of anti-transglutaminase IgA antibodies was 2.8%.

Screening for the two most common chronic diseases in pediatric age involved 5,363 children, reached thanks to the collaboration of 429 private pediatricians. The children were distributed in three age classes, 2, 6 and 10 years, and underwent analysis to identify specific antibodies for DT1 and CD through screening tests on capillary sampling.

“ These data - underline Marco Silano, head of the project at the ISS for the part on T1D, and Umberto Agrimi, for the part on CD - suggest a prevalence of autoantibodies against T1D comparable to that of other European countries, while for CD it is possible that there is an increase compared to the estimates made so far, which however can only be quantified with a larger sample and after diagnostic verification”. The preliminary study analyzed the main factors for the implementation of screening at a national level, “highlighting the high availability of both family pediatricians and analytical laboratories to participate in the project, and also showed the effectiveness of screening in asymptomatic subjects, favoring the activation of follow-up programs and timely therapeutic interventions, with the aim of preventing or significantly reducing complications in both the short and long term”.

“The results of the project - comments Nicola Zeni, president of the Italian Diabetes Foundation (FID), who spoke at the conference promoted by the Istituto Superiore di Sanità - have demonstrated the feasibility of large-scale screening for type 1 diabetes and celiac disease and represent a valuable opportunity to give new impetus to the implementation of Law 130/2023. Now we need to speed up the implementing decrees that will allow the regulation to be applied throughout the country, extending screening at a national level”. This is how the results of “D1Ce Screen” were presented.