World-first childhood diabetes study extended

JDRF Australia and funding partner The Leona M. and Harry B. Helmsley Charitable Trust (Helmsley) have announced a combined additional $12 million towards the continuation of the Environmental Determinants of Islet Autoimmunity (ENDIA) study.

The ENDIA study, led by Professor Jennifer Couper from the University of Adelaide, the Robinson Research Institute and the Women’s and Children’s Hospital, is the world’s first and largest study to identify how genetics and the environment interact from pregnancy through early childhood to drive or protect against the development of type 1 diabetes, a life-long autoimmune condition that destroys the body’s cells that make insulin.

Over the last 10 years, almost 1,500 Australian children with an immediate family member living with type 1 diabetes have been recruited to the ENDIA study and followed from the pregnancy into childhood to investigate why some children develop type 1 diabetes, while others do not.

The first stages of type 1 diabetes can be detected in the first few years of life, so interventions to prevent type 1 diabetes need to begin early, perhaps even before birth.

“Professor Couper’s research into the prevention of type 1 diabetes is expected to have a major positive impact for people across Australia,” said Professor Anton Middelberg, Deputy Vice-Chancellor and Vice-President (Research), the University of Adelaide.

“The University of Adelaide prides itself on being a magnet for attracting and retaining talent who together produce world-leading research that solves real-world problems.”

Professor Couper, ENDIA Principal Investigator, Head of the Discipline of Paediatrics at the University of Adelaide and Paediatric Endocrinologist at the Women’s and Children’s Hospital, said that the study’s over-arching purpose is to develop treatments to prevent childhood type 1 diabetes. 

“ENDIA has brought together expertise in Australia to provide the best chance of discovering what drives type 1 diabetes in early life,” said Professor Couper.

“Recently, our funders have extended invitations for researchers world-wide to access ENDIA data and samples, creating exciting opportunities for collaboration.

“Additionally, ENDIA is committed to improving the health and wellbeing of expectant mothers with type 1 diabetes, and their babies.”

The study has also provided immediate benefits to 21 children who have been diagnosed early with type 1 diabetes through the study, as well as a further 189 children who have been identified to be at heightened risk.

Early diagnosis - identifying those with early signs of disease before symptom onset - can help prevent complications often seen at childhood type 1 diabetes onset like severe diabetic ketoacidosis (DKA), a life-threatening diabetes complication where the body produces excess blood acids (ketones), that occurs when there isn’t enough insulin in the body.

"ENDIA has brought together expertise in Australia to provide the best chance of discovering what drives type 1 diabetes in early life."Professor Jennifer Couper

Many factors such as viral infections, bacteria in the gut, the immune system, nutrition, and more, can interact with our genes to make some children more likely to develop type 1 diabetes. ENDIA aims to understand how these interactions influence the progression of the condition.

JDRF Chief Scientific Officer, Dr Dorota Pawlak, said that ENDIA has been instrumental in positioning Australia as a global leader for type 1 diabetes prevention.

“ENDIA was the first study of its kind in the world and is increasingly recognised as the gold standard for understanding how gestational and early life exposures influence the onset of type 1 diabetes,” said Dr Pawlak.

“These advancements have been made possible thanks to funding from the Government and the generosity from Helmsley.”

The $12 million investment builds on eight years of partnership, with a total commitment to date of $40 million to ENDIA: $13 million from the T1DCRN, and $27 million from Helmsley. 

Dr Anne Koralova, Program Officer at The Leona M. and Harry B. Helmsley Charitable Trust, said that ENDIA represents the research progress made possible through longstanding collaboration:

“At Helmsley, we are committed to building a future where we can identify those at risk for type 1 diabetes and provide interventions to prevent disease development in the first place,” said Dr Koralova.

“That’s why we are invested in ENDIA — their research holds great promise to make that future a reality.”