Status:

RECRUITING

EXtremely Early-onset Type 1 Diabetes EXtremely Early-onset Type 1 Diabetes (A Musketeers' Memorandum Study)

Lead Sponsor:

University of Exeter

Collaborating Sponsors:

Royal Devon and Exeter NHS Foundation Trust

King's College London

Conditions:

Type1 Diabetes Mellitus

Eligibility:

All Genders

Up to 70 years

Brief Summary

Type 1 diabetes (T1D) results from destruction of insulin-producing beta cells in the pancreas by the body's own immune system (autoimmunity). It is not fully understood what causes this type of diabe...

Detailed Description

Type 1 diabetes (T1D) is a common autoimmune disease that causes destruction of pancreatic, insulin producing beta cells, leading to high blood glucose. T1D is regarded as a childhood disease with an ...

Eligibility Criteria

Inclusion

  • Study 1:
  • EET1D
  • Aged 0 to 70 years
  • Clinical diagnosis of diabetes \<24 months (+ evidence of WHO diabetes criteria)
  • Negative genetic test for mutations causing non-autoimmune neonatal diabetes if diagnosed \<12 months
  • Type 1 diabetes genetic risk score \>50th centile of T1D reference group, or monogenic cause of T1D.
  • T1D Controls
  • Age 0-70 years (matched to above)
  • Clinical diagnosis of T1D (diagnosed age 1-20 years)
  • Insulin treated from diagnosis.
  • Monogenic / NDM controls
  • Diagnosis of diabetes \<12 months
  • Diagnosis of monogenic / NDM (confirmed by Exeter Molecular Genetics Laboratory).
  • Study 2:
  • EET1D
  • Aged 0 to 24 months at recruitment
  • Clinical diagnosis of diabetes \<24 months (+ evidence of WHO diabetes criteria)
  • Negative genetic test for mutations causing non-autoimmune neonatal diabetes
  • Type 1 diabetes genetic risk score \>50th centile of T1D reference group, or monogenic cause of T1D.
  • Monogenic/NDM controls
  • Diagnosis of diabetes \<24 months
  • Age 0 to 18 months at recruitment
  • Diagnosis of monogenic/NDM (confirmed by Exeter Molecular Genetics Laboratory).
  • Non-diabetic controls
  • Aged 0-6 years
  • Attending specified participating hospital sites for elective surgery, including but not limited to: inguinal hernia repair, umbilical/midline hernia repair, orchidopexy, gastrostomy insertion/change, hypospadias repair, cleft palate repair, excision of accessory digit, laryngoscopy, adenoidectomy, tonsillectomy, MRI under general anaesthesia, eye surgery.

Exclusion

  • Study 1:
  • Aged \>70 years
  • No diagnosis of diabetes
  • MODY (e.g. caused by HNF1A/HNF4A/HNF1B/GCK mutations), type 2 diabetes or diabetes related to pancreatic insufficiency or syndromic diabetes
  • Intercurrent illness at time of sampling for PBMCs (see below).
  • Study 2:
  • Aged \>24 months
  • Clinical diagnosis of diabetes \>24 months
  • Intercurrent illness at time of sampling for PBMCs or RNA (see below).
  • Non-diabetic controls:
  • Aged \>6 years
  • Diagnosis of diabetes or other autoimmune condition
  • Known immunological disorder
  • On immunosuppressive medication
  • Ongoing infections/sepsis
  • Major congenital abnormality or significant systemic illness that may affect the immune system, e.g. metabolic disease, 22q deletion syndrome
  • Recent (within two weeks) febrile illness
  • Renal failure.
  • For PBMC and RNA sampling: Exclusion for factors that may alter T cell function and RNAseq
  • Review the following exclusion criteria carefully at time of appointment as some details may have changed since initial contact:
  • Recreational drug use (excluding cannabis use more than 1 week prior to blood sampling) - drug abuse may alter T cell function
  • Alcohol related illness (excessive alcohol consumption may alter T cell function)
  • Renal failure: Creatinine \>200 (as may alter T cell function)
  • Any other medical condition which, in the opinion of the investigator, would affect the safety of the subject's participation.
  • Factors that if temporary would lead to rearrangement of study visit but if long duration, may lead to exclusion subject to the CI's discretion:
  • Pregnant or lactating (as this may limit blood sampling and affect T cell function)
  • Any infectious illness within the last 2 weeks if it was a febrile illness, or within 2-3 days if it was non-febrile (as this may activate T cells non-specifically)
  • Taking steroids or other immunosuppressive medications (as these may alter T cell function)
  • Received any immunoglobulin treatments or blood products in the last 3 months (as these may alter T cell function).

Key Trial Info

Start Date :

September 19 2017

Trial Type :

OBSERVATIONAL

Allocation :

ESTIMATED

End Date :

November 30 2028

Estimated Enrollment :

300 Patients enrolled

Trial Details

Trial ID

NCT03369821

Start Date

September 19 2017

End Date

November 30 2028

Last Update

December 19 2025

Active Locations (4)

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Page 1 of 1 (4 locations)

1

Benaroya Research Institute

Seattle, Washington, United States, 98101-2795

2

Leiden University Medical Center

Leiden, Leiden, Netherlands, 2333 ZA

3

Royal Devon & Exeter NHS Foundation Trust

Exeter, Devon, United Kingdom, EX2 5DW

4

King's College London

London, United Kingdom, SE1 9RT