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As part of the Fr1da study, “Early detection and early treatment of type 1 diabetes”, led by researchers at the Institute of Diabetes Research at Helmholtz Munich, families can have their children aged two to ten tested for an early stage of type 1 diabetes. From May 2026, the study will expand its program by five additional federal states, bringing the total to 12: Berlin, Brandenburg, Mecklenburg-Western Pomerania, Saxony-Anhalt, and Thuringia will be added. Until now, the program had been available in Bavaria, Bremen, Hamburg, Hesse, Lower Saxony, Rhineland-Palatinate, and Saxony.
Type 1 diabetes often begins long before children develop symptoms. In this early phase, specific antibodies can already be detected in the blood – so-called islet autoantibodies directed against components of the insulin-producing islet cells in the pancreas. This is where Fr1da comes in: the study systematically searches the general population for early, still asymptomatic stages of type 1 diabetes and then classifies the stage of disease more precisely. In this way, Fr1da helps to detect the disease earlier, improves the understanding of the disease progression, and provides a scientific basis for more targeted prevention and intervention strategies.
Fewer Cases of Diabetic Ketoacidosis
Since 2015, pediatric practices in the participating federal states have tested more than 240,000 children as part of the Fr1da study. Researchers identified an early stage of type 1 diabetes in more than 730 children. A recent analysis shows that early diagnosis can be clinically relevant: Only 2.5 percent of the children identified through Fr1da developed diabetic ketoacidosis at the onset of the disease, a dangerous metabolic complication caused by severe insulin deficiency. Without early diagnosis, this rate has been above 20 percent in Germany for years.
If Fr1da detects an early stage of type 1 diabetes in a child, the team invites the family for further examinations at a pediatric diabetes clinic. There, physicians determine which disease stage the child is in: still normal glucose metabolism, first metabolic changes, or already manifest type 1 diabetes. Based on this, they establish a prevention plan with follow-up appointments; children with manifest type 1 diabetes are then referred to standard care.
Fr1da Creates Time for Education, Prevention, and Treatment
“With Fr1da, we do not first see type 1 diabetes when children become acutely ill, but much earlier,” says Prof. Anette-Gabriele Ziegler, Director of the Institute of Diabetes Research at Helmholtz Munich and scientific lead of the Fr1da study. “This creates time for education, prevention, and, where appropriate, medical intervention, while also helping us better understand the causes and course of the disease.”
To do this, Fr1da relies on a network of pediatric practices, laboratories, and pediatric diabetes centers built up over many years. “Our experience over the past several years shows that Fr1da screening can be well integrated into the daily routine of pediatric practices and is very well accepted by families. I very much hope that we will succeed in transitioning Fr1da into selective care or even into standard care,” says Dr. Michael Hubmann, President of the Berufsverband der Kinder- und Jugendärzt*innen e.V., German Association of Paediatric and Adolescent Care Specialists (BVKJ).
One in 250 Children Develops Type 1 Diabetes
Type 1 diabetes is not a rare disease: in Germany, around one in 250 children develops it. With the expansion to 12 federal states, Fr1da will now reach a large proportion of the population, as Ziegler emphasizes: “Far more children now have the opportunity to take part in Fr1da.” At the same time, this step shows that early detection is becoming increasingly important not only scientifically, but also from a health policy perspective: in the long term, access to it should not depend on where a child lives.
To support the expanded Fr1da program, the team has established a second central laboratory in Dresden alongside the central laboratory in Munich. Families and practices are also supported by three regional coordination centers in Munich, Dresden, and Hanover. Further information is available at www.fr1da.de. Questions can also be directed to the Fr1da hotline at 0800 464 88 35 or by email at diabetes.frueherkennung@helmholtz-munich.de
About the Researchers
Prof. Anette-Gabriele Ziegler is Director of the Institute of Diabetes Research at Helmholtz Munich and Chair of Diabetes and Gestational Diabetes at the TUM University Hospital.
Prof. Peter Achenbach is Deputy Director of the Institute of Diabetes Research at Helmholtz Munich.
About Helmholtz Munich
Helmholtz Munich is a leading biomedical research center. Its mission is to develop breakthrough solutions for better health in a rapidly changing world. Interdisciplinary research teams focus on environmentally triggered diseases, especially the therapy and prevention of diabetes, obesity, allergies, and chronic lung diseases. With the power of artificial intelligence and bioengineering, researchers accelerate the translation to patients. Helmholtz Munich has more than 2,550 employees and is headquartered in Munich/Neuherberg. It is a member of the Helmholtz Association, with more than 46,000 employees and 18 research centers the largest scientific organization in Germany. More about Helmholtz Munich (Helmholtz Zentrum München Deutsches Forschungszentrum für Gesundheit und Umwelt GmbH): www.helmholtz-munich.de/en
https://www.typ1diabetes-frueherkennung.de/ Fr1da-Studie: Diabetes Früherkennung
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