P-317: Integrated screening for type 1 diabetes and celiac disease: preliminary results of the SCREEND1A pilot program in Spain
M Gonzalez-Arceo, X Irusta, I Urrutia, R Martinez, B Calvo, N Trebolazabala, V Lago, A Santamaria, N Muñoz-Llanes, R Rodriguez, T Perez, I Rica, N Valdes, C Fernandez-Ramos, L Castano, , SCREEND1A Working GroupAbstract
Introduction
Type 1 diabetes (T1D) and celiac disease (CD) are rising autoimmune conditions manifesting at any age. Presymptomatic detection via specific autoantibodies, islet-Abs (IAA, GADA, IA2A, ZnT8A) for T1D and anti-tissue transglutaminase (tTGA) for CD, prevents severe acute complications. Since both disorders share a genetic background and novel immunotherapies can delay T1D progression, a combined tTGA and islet-Abs screening offers an efficient approach for simultaneous early detection.
Objectives
To present preliminary results of the SCREEND1A pilot screening program in Spain, evaluating its feasibility and detection capacity for T1D and CD across general population (GP) and first-degree relatives (FDRs) of patients with T1D.
Methods
SCREEND1A recruits GP individuals at primary care during well-child visits and FDRs at reference hospitals, involving 21 centers across the Basque Country and Asturias. Centralized venous blood samples are analyzed at Cruces University Hospital for islet-Abs via RBA, and tTGA via FEIA. Positive islet-Abs are confirmed by ADAP and undergo specialized follow-up.
Results
1,119 individuals were enrolled: 498 FDRs (36.3% ≤18 years, 50.2% female) and 621 GP (77.1% ≤18 years, 55.4% female). T1D-Abs detection was higher in FDRs than GP, driven by the youth group (≤18 years) in both cohorts (7.7% vs 2.3%). Most positive cases presented a single autoantibody (6.1% FDRs, 2.1% GP). High clinical risk, defined by multiple positivity, was 0.2% in GP, but reached 1.7% in youth FDRs (Table 1). Additionally, 1% of 379 individuals screened for tTGA (63.8% ≤18 years, 57.4% female) tested positive. All confirmed cases are under specialized follow-up.
Conclusions
SCREEND1A constitutes a feasible integrated T1D/CD screening model within a Public Health System. While GP screening enables broader detection, targeted surveillance of FDRs, especially in youth, remains vital to identify high-risk individuals.