Abstract
Aims: To evaluate the feasibility of using self-collected capillary blood samples for islet autoantibody testing to identify risk in relatives of people with type 1 diabetes.
Methods: Participants were recruited via the observational TrialNet Pathway to Prevention study, which screens and monitors relatives of people with type 1 diabetes for islet autoantibodies. Relatives were sent kits for capillary blood collection, with written instructions, an online instructional video link and a questionnaire. Sera from capillary blood samples were tested for autoantibodies to glutamic acid decarboxylase (GADA), islet antigen-2 (IA-2A), insulin (IAA), and zinc transporter 8 (ZnT8A). ‘Successful’ collection was defined as obtaining sufficient volume and quality to provide definitive autoantibody results, including confirmation of positive results by repeat assay.
Results: In 240 relatives who returned samples, the median age was 15.5 years (range 1-49) and 51% were male. Of these samples, 98% were sufficient for GADA/IA-2A/ZnT8A, and 84% for IAA testing and complete autoantibody screen. The upper 90% confidence bound for unsuccessful collection was 4.4% for GADA, IA-2A and/or ZnT8A assays, and 19.3% for IAA. Despite 43% of 220 questionnaire respondents finding capillary blood collection uncomfortable or painful, 82% preferred home self-collection of capillary blood samples compared with outpatient venepuncture (90% <8 years, 83% 9-8 years and 73% >18 years). The perceived difficulty of collecting capillary blood samples did not affect success rate.
Conclusions: Self-collected capillary blood sampling offers a feasible alternative to venous sampling, with the potential to facilitate autoantibody screening for type 1 diabetes risk.
Methods: Participants were recruited via the observational TrialNet Pathway to Prevention study, which screens and monitors relatives of people with type 1 diabetes for islet autoantibodies. Relatives were sent kits for capillary blood collection, with written instructions, an online instructional video link and a questionnaire. Sera from capillary blood samples were tested for autoantibodies to glutamic acid decarboxylase (GADA), islet antigen-2 (IA-2A), insulin (IAA), and zinc transporter 8 (ZnT8A). ‘Successful’ collection was defined as obtaining sufficient volume and quality to provide definitive autoantibody results, including confirmation of positive results by repeat assay.
Results: In 240 relatives who returned samples, the median age was 15.5 years (range 1-49) and 51% were male. Of these samples, 98% were sufficient for GADA/IA-2A/ZnT8A, and 84% for IAA testing and complete autoantibody screen. The upper 90% confidence bound for unsuccessful collection was 4.4% for GADA, IA-2A and/or ZnT8A assays, and 19.3% for IAA. Despite 43% of 220 questionnaire respondents finding capillary blood collection uncomfortable or painful, 82% preferred home self-collection of capillary blood samples compared with outpatient venepuncture (90% <8 years, 83% 9-8 years and 73% >18 years). The perceived difficulty of collecting capillary blood samples did not affect success rate.
Conclusions: Self-collected capillary blood sampling offers a feasible alternative to venous sampling, with the potential to facilitate autoantibody screening for type 1 diabetes risk.
| Original language | English |
|---|---|
| Pages (from-to) | 934-937 |
| Number of pages | 4 |
| Journal | Diabetic Medicine |
| Volume | 34 |
| Issue number | 7 |
| Early online date | 8 Mar 2017 |
| DOIs | |
| Publication status | Published - Jul 2017 |
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This is the author accepted manuscript (AAM). The final published version (version of record) is available online via Wiley at http://onlinelibrary.wiley.com/doi/10.1111/dme.13338/abstract. Please refer to any applicable terms of use of the publisher.