Precision Prediction & Precision Medicine

The EDDDY-S study is an ongoing research project designed to find ways to help clinicians better assess risks in children and adolescents with type 1 diabetes.


Risk assessment, which includes identifying the stage to which the disease has progressed in the individual patient, is just as important in children and adolescents as it is in adults. If we can identify individuals who are at an increased risk of developing a specific complication, or who already show early signs of complications, action can be taken to address this, including the use of additional and/or more intensive treatment.


The EDDDY-S study is investigating new techniques for identifying early signs of micro- and macrovascular complications. Traditionally, surrogate endpoints and early signs of complications have included:

  • HbA1c
  • Neurological physical examination
  • Albumin excretion ratio (AER)
  • Atherogenic profile, including apolipoprotein B (Apo B), highly-sensitive C-reactive protein (Hs-CRP), and complement component 3 (C3)
  • Objective neurological examination, by assessment of sudomotor function and pupillometry


Newer endpoints and early signs include:

  • Advanced glycation endproducts (AGEs), measured by auto-fluorescence
  • Intima-media thickness (IMT) of the carotid artery
  • Neuropad test to measure sudomotor function


Sub-studies of EDDDY-S are addressing each of these newer endpoints/signs, with the aim of investigating their applicability in children and adolescents with type 1 diabetes, and if they can be usefully integrated along with older endpoints/signs into a more effective staging system for risk assessment.


Diabeter is ideally placed to conduct such research: the sub-study populations include patients attending our outpatient clinics, with the new tests and evaluations incorporated into the standard battery of assessments.

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