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Month: January 2026

National childhood type 1 diabetes screening could prevent thousands of emergency diagnoses, Birmingham study shows

Written by Louise Stanley on . Posted in Birmingham Health Partners, Early diagnosis and detection, Inflammation and chronic disease.

A landmark UK study led by researchers at BHP founder members the University of Birmingham – which involved tens of thousands of families – has shown that childhood screening for type 1 diabetes is effective, laying the groundwork for a UK-wide childhood screening programme.

Results from the first phase of the ELSA (EarLy Surveillance for Autoimmune diabetes) study, co-funded by charities Diabetes UK and Breakthrough T1D, are published today in The Lancet. 

The findings mark a major step towards a future in which type 1 diabetes can be detected in children before symptoms appear. Currently, over a quarter of children with type 1 diabetes don’t receive a diagnosis until they are already in diabetic ketoacidosis (DKA), a potentially fatal condition that requires urgent hospital treatment. Early detection can dramatically reduce emergency diagnoses and could give children access to new immunotherapy treatments that can delay the need for insulin for years.

Launched in 2022, ELSA is the first UK study of its kind, the study tested blood samples for autoantibodies, markers of type 1 diabetes that can appear years before symptoms.  

We know that risk rises sharply with the number of autoantibodies. Children without autoantibodies are unlikely to develop type 1 diabetes, while those with one autoantibody have a 15% chance of developing the condition within 10 years. Having two or more autoantibodies indicates the immune system has already started attacking the insulin-producing cells in the pancreas and it is therefore almost certain these children will eventually need insulin therapy. This is known as early-stage type 1 diabetes.

Among the 17,283 children aged 3-13 years who were screened for type 1 diabetes risk at the time of analysis: 

  • 75 had one autoantibody, signalling increased future risk. 
  • 160 had two or more autoantibodies but did not yet require insulin therapy, indicating early-stage type 1 diabetes. 
  • 7 were found to have undiagnosed type 1 diabetes with all needing to start insulin immediately.  

Families of children found to have early-stage type 1 diabetes received tailored education and ongoing support to prepare for the eventual onset of type 1 diabetes symptoms and to ensure insulin therapy can begin promptly when needed, reducing the chances of needing emergency treatment. Those with one autoantibody also received ongoing support and monitoring.

Some families were also offered teplizumab, the first ever immunotherapy for type 1 diabetes, which can delay the need for insulin by around three years  in people with early-stage type 1 diabetes. The first patient was treated at Birmingham Children’s Hospital, demonstrating the hive of cutting-edge diabetes activity in and around Birmingham Health Partners and the Birmingham health and life sciences district. Teplizumab was licensed by the Medicines and Healthcare products Regulatory Agency (MHRA) in the UK in August 2025, and is currently being assessed by the National Institute for Health and Care Excellence (NICE) to determine whether it should be available through the NHS.

As of November 2025, more than 37,000 families had signed up to the ELSA programme and, building on this strong foundation, the second phase of the research launches today. ELSA 2 will expand screening to all children in the UK aged 2-17 years, with a focus on younger children (2-3 years) and older teenagers (14-17 years). The research team aims to recruit 30,000 additional children across these new age groups.

ELSA 2 will also establish new NHS Early-Stage Type 1 Diabetes Clinics, providing families taking part in the study with clinical and psychological support and creating a clear pathway from screening to diagnosis, monitoring and treatment.

Amy Norman, 44, from the West Midlands, was diagnosed with type 1 diabetes at the age of 13. She recently discovered via the ELSA study that her 11-year-old daughter, Imogen, is in the early stages of type 1 diabetes but has been able to slow its progression as the second child in the UK to access a breakthrough immunotherapy drug – teplizumab. She said: “Being part of the ELSA study has helped us as a family to prepare for the future in a way we never expected. Knowing what’s coming – rather than being taken by surprise – has made an enormous difference to our confidence and peace of mind.

“When I was diagnosed, I had no warning and ended up quite poorly in hospital with diabetic ketoacidosis (DKA). When Imogen’s diagnosis arrives, we hope that having this awareness will reduce her chances of experiencing DKA and the added trauma that comes from a sudden illness.

“Imogen took part in the study to further research and help others, but it has helped her too – being forewarned is being forearmed. She was always going to develop type 1 diabetes, but through ELSA we’ve been able to slow down the process and prepare – we know what is coming, but we’re not scared.” 

Lead researcher, Parth Narendran, Professor of Diabetes Medicine at the University of Birmingham, said: “We are extremely grateful to all the families who have participated in the study and generously given their time to help understand how a UK-wide screening programme could be developed. Together with Diabetes UK, Breakthrough T1D and NICE, we are working towards a future where type 1 diabetes can be detected in a timely manner, and families appropriately supported and treated with medicines to delay the need for insulin.

“We are also grateful to partners across the Birmingham health and life sciences district and beyond as well as the NIHR for the support they have provided in getting us to where we are.”

Dr Elizabeth Robertson, Director of Research and Clinical at Diabetes UK, said: “For too many families, a child’s type 1 diabetes diagnosis still comes as a frightening emergency. But that doesn’t have to be the case. Thanks to scientific breakthroughs, we now have the tools to identify children in the very earliest stages of type 1 diabetes – giving families precious time to prepare, avoid emergency hospital admissions, and access treatments that can delay the need for insulin for years.

“The ELSA study, co-funded by Diabetes UK, is generating the evidence needed to make type 1 diabetes screening a reality for every family in the UK. We’re incredibly grateful to the 37,000 families who’ve already signed up and urge others to get involved. Together, we can transform type 1 diabetes care for future generations.”

Rachel Connor, Director of Research Partnerships at Breakthrough T1D, said: “This is about rewriting the story of type 1 diabetes for thousands of families. Instead of a devastating emergency, we can offer time, choices, and hope. By finding children in the earliest stages, we’re not just preparing families, we’re opening the door to treatments that can delay the need for insulin by years. That extra time means childhoods with fewer injections, fewer hospital visits and more normality. Thanks to research like ELSA, what once struck as an unexpected crisis can become an actively managed healthcare process, changing the course of T1D for the better.”

The Research FIRST team at Birmingham Health Partners has played a pivotal role in the successful delivery of the ELSA study. Drawing on extensive specialist expertise, the team developed and implemented a robust, resilient database to support high-quality data capture and long-term study integrity.

Beyond technical delivery, the team also provided dedicated data management support throughout the project, ensuring rigorous standards, regulatory compliance and operational efficiency. They also offered oversight across key project activities, working closely with participating sites to support recruitment and ensure timely follow-up.

The team’s co-ordination and proactive problem-solving were instrumental in keeping the study on track. A further major achievement was the end-to-end management of dry blood spot testing kit dispatch, enabling sites to begin screening as quickly as possible after families signed up. This comprehensive project management has been critical in maintaining momentum and supporting the continued success of the study, enabling researchers to continue their work with confidence.

The findings from ELSA’s first phase signal a major step towards a future in which type 1 diabetes can be detected early, managed proactively, and potentially delayed through immunotherapy. ELSA demonstrates that childhood screening in the UK is feasible, acceptable to families, and capable of preventing emergency diagnoses. Continued research through ELSA 2 will assess how screening can be scaled across the NHS and evaluate its cost-effectiveness.

Type 1 diabetes is a serious and lifelong autoimmune condition affecting up to 400,000 people in the UK. It is caused by an immune system attack on the insulin-producing cells in the pancreas, meaning they can no longer make enough insulin. Rapid diagnosis of type 1 diabetes is essential to avoid life-threatening complications. 

For more information about ELSA or ELSA 2, visit elsadiabetes.nhs.uk/taking-part/. 

Simple tool predicts mental health and treatment needs for new inflammatory bowel disease patients

Written by Louise Stanley on . Posted in Early diagnosis and detection, Inflammation and chronic disease, Mental health.

Researchers at BHP founding-members the University of Birmingham and University Hospitals Birmingham NHS Foundation Trust, delivered through the National Institute for Health and Care Research (NIHR) Birmingham Biomedical Research Centre (BRC), have shown how early use of the IBD Disk questionnaire can help forecast which patients are likely to experience more severe physical and mental health outcomes over the following year.

More than half a million patients in the UK have inflammatory bowel disease (IBD), and research suggests that up to 30% experience mental ill health as a result. Now, a new study outlines how many of the 25,000 new patients diagnosed each year could receive more tailored mental health support thanks to a simple tool that identifies psychological distress and predicts disease severity.

The paper published in Frontiers in Gastroenterology shows how a patient-reported questionnaire called IBD Disk – currently used to track impact of disease on daily life – can also be powerful prediction tool, detecting anxiety and depression symptoms from the outset of a patient’s diagnosis for the inflammatory condition.

The Birmingham study is the first to show that the tool can be used at the point of diagnosis to identify patients at risk of mental health challenges and predict who may need more intensive treatment.

This dual-purpose use – both as a mental health screener and a predictor of disease trajectory – could help clinicians intervene earlier and personalise care for patients more effectively.

Dr Peter Rimmer, lead author of the study, researcher at the University of Birmingham and Consultant Gastroenterologist at University Hospitals Birmingham NHS Foundation Trust said: “This is the first time we’ve shown that the IBD Disk can act as both a mental health screener and a predictive tool for clinical outcomes at the very start of a patient’s journey.

“The findings support the use of the IBD Disk not only as a disability tracker, but as a proactive tool to guide early treatment decisions and mental health support. It’s a simple intervention that could help personalise care and reduce long-term burden on the NHS.”

Mental health conditions more common for IBD patients

Mental health conditions including anxiety and depression are more common in people with established IBD than in the general population, with some studies suggesting that 20-30% of patients are affected by mood disorders.

However, very few studies have been undertaken among patients when they are first diagnosed – at a time when their new IBD symptoms and uncertainty around diagnosis can contribute to psychological distress.

This study found that patients with higher levels of disease-associated physical disability and psychological distress at diagnosis were more likely to need escalating treatments such as stronger medication or surgical interventions, or require an emergency admission to hospital later on – adding to growing evidence that early identification of these symptoms could play a key role in improving long-term outcomes for people with IBD.

The study followed 188 patients attending a rapid-access clinic for suspected IBD who were subsequently diagnosed with either Crohn’s Disease or Ulcerative Colitis. At their first visit – before diagnosis – patients completed the IBD Disk, and a subgroup also completed the Hospital Anxiety and Depression Scale (HADS) to assess mental health. After diagnosis, patients were treated according to standard clinical guidelines and followed for 12 months.

Researchers analysed whether scores on the IBD Disk, particularly in the “Emotions” domain, could identify patients with moderate to severe anxiety or depression symptoms, and whether those scores predicted the need for advanced therapies, hospitalisation, and persistent disease activity.

Statistical analysis showed that an “Emotions” score of 7 or higher was highly correlated with moderate to severe depression symptoms. Patients with higher IBD Disk scores at diagnosis were significantly more likely to experience poor clinical outcomes, especially those with ulcerative colitis. Where medical treatments were not effective and their IBD remained active, patients were more likely to experience ongoing symptoms of psychological distress.

The study involved collaborators from Hoffmann-La Roche, Beaumont Hospital Dublin, and Royal Wolverhampton NHS Trust. Hoffmann-La Roche provided funding for the study and the Roche author participated in manuscript writing, review and editing.

West Midlands Living Lab: connecting healthcare through technology

Written by Louise Stanley on . Posted in Health inequalities.

A new initiative will see researchers work with digital technology leaders and industry to meaningfully impact healthcare services and improve patient outcomes in the Midlands.

The West Midlands Living Lab will explore the use of digital technology to improve patient communication, enable community care, avoid unnecessary hospital admissions, and support a more prevention-based health service.

Working with worldwide technology giant Cisco, BHP founder-member the University of Birmingham will lead the latest of the Lister Alliance Living Labs in the country’s richly diverse second city. With approximately 6.2 million people, and more than 100 languages spoken, the diverse West Midlands population truly reflects the global community. Research conducted in the region will be widely applicable, meaning it provides the ideal test bed.

University Hospitals Birmingham’s Professor Simon Ball, who is also Senior Responsible Officer for the West Midlands Secure Data Environment and co-lead for the living lab said: “The West Midlands is the perfect place to do this innovative work, with our leading researchers bringing together key stakeholders to connect state-of-the-art NHS facilities and uniquely diverse local communities. Working with an industry partner with the capability and reach of Cisco working alongside us is a testament to the scale of our ambition and drive to improve health outcomes using innovative technology and analytics.”

Professor Neil Hanley, Pro Vice Chancellor and Head of College of Medicine and Health, said: “We’re delighted that the University of Birmingham, led by Professor Kotecha, is at the forefront of this collaboration. It was great to attend the recent launch event and inspiring to feel the cross-sector work- the genuine triple helix of universities, public sector and industry – all focussed on stopping readmission to hospital and, in particular, addressing the health inequalities associated with this. Aligning all this with skills, innovation, entrepreneurship and commercialisation really excites me. And of course, with the make-up of Birmingham and the West Midlands being the demographic of the world, lessons learned and experiences gained will be rapidly translatable across the UK and internationally.”

The West Midlands Living Lab, funded by Cisco’s Country Digital Acceleration programme, will take advantage of considerable and unique health data resources, including the West Midlands Secure Data Environment which is connecting health systems across the region, and DaRe2THINK, which provides a national digital clinical trial platform for NHS Primary Care.

Pilot studies are planned to run through community hubs, NHS Primary Care and hospital trusts, looking at how best to break down siloes between existing services and orchestrate better, connected health and social care. Partnerships with community organisations will help address the needs of diverse neighbourhoods and be a blueprint for global benefit.

Professor Dipak Kotecha, School of Medical Sciences, University of Birmingham, said: “Our new living lab focused on health technology will allow us to bring together health data and industry partners to innovate towards better healthcare for all. This includes exploring technologies for remote monitoring, developing AI tools for prediction, improving how people get discharged from hospital, and integrating health data to keep people informed and well in their own homes.

“For example, our previous research, now adopted into the NHS 10-year plan, has shown that wearable devices for health monitoring can provide information similar to that recorded at hospital visits. These early indications show promise for a less hospital-centric and more personalised approach to care, delivered in the community by using new healthtech.”

Declan Hadley, Healthcare Lead, Cisco UKI, said: “We are looking forward to harnessing the creativity, experience and collective capabilities in the West Midlands to improve routine NHS care through technology but also need to be mindful that we don’t exacerbate existing heath inequalities. Living labs are just as much about finding out what does work as what doesn’t, and we plan to achieve this through co-production with local community leaders.”

International initiative to tackle heart health inequalities in cities to be led from Birmingham

Written by Louise Stanley on . Posted in Health inequalities, Inflammation and chronic disease.

Researchers from BHP founder the University of Birmingham will collaborate with international partners on an ambitious project aiming to help reduce the burden of cardiovascular disease in urban environments, as well as reducing the health inequality gap.

Cardiovascular disease is the leading cause of death globally, accounting for over 20 million deaths per year and costing the EU an estimated €282bn annually. To tackle this, the European Union Innovative Health Initiative has funded the new Cities@Heart consortium which will design, pilot and evaluate a series of city-level strategies to improve cardiovascular health for all.

Addressing cardiovascular disease in urban environments is challenging due to factors like poor access to healthcare and healthy food, exposure to pollution, and lack of safe spaces for physical activity. Urban infrastructure, food systems, and socio-economic disparities also contribute to adverse cardiometabolic outcomes.

While there are many interventions for cardiovascular disease, a lack of effective implementation means these often fail to reach individuals who would benefit most. This is particularly evident in underserved city populations such as those experiencing poverty, and in certain ethnic groups, disabled people, and women.

Addressing these complex issues requires a whole-city, integrated approach that changes health policy through co-production of suitable interventions with communities and community leaders.

The Cities@Heart project, starting in January 2026 and coordinated by the University of Birmingham, the University Medical Center Utrecht (Netherlands) and Novartis (Switzerland), will combine medical, technical, social and policy innovations to achieve a transformation in outcomes for communities experiencing health inequality.

Led by Professor Dipak Kotecha, the project will utilise existing infrastructure from seven city councils across Europe, embedding new health innovations and technologies from industry partners to tackle the challenge of urban cardiovascular disease on a significant scale.

The strategies will target obesity, hypertension, dyslipidaemia and diabetes, key drives of common and high-cost cardiovascular disease, such as heart attacks, stroke, heart failure, atrial fibrillation and vascular dementia. These disproportionately impact underserved and disadvantaged communities in urban areas.

Professor Dipak Kotecha, Professor of Cardiology at the University of Birmingham, researcher at the National Institute for Health and Care Research (NIHR) Birmingham Biomedical Research Centre, through which this project will be delivered, Honorary Professor at the University Medical Center Utrecht and Global Director of Cities@Heart said: “Huge strides have been made to better manage disease of the heart and circulation, but they still remain the world’s biggest killers. We will jointly develop approaches with affected citizens, community leaders, city councils, clinicians, health policy leaders and industry partners to achieve long-term change.”

Collaboration across Europe

The project consortium involves 34 international partners, including the World Health Organization (WHO) European Healthy Cities Network, World Heart Federation, European Heart Network, European Society of Cardiology, European Public Health Association and multiple European universities.

Birmingham joins another six cities committed to city-wide improvement that will test and implement strategies that can be scaled across the WHO’s network of more than 1,800 cities: Belfast (Northern Ireland), Cork (Republic of Ireland), Łódź (Poland), Izmir (Turkey), Udine (Italy) and Utrecht (Netherlands).

The vision of the consortium is that evidence-based prevention, early detection, and management of cardiovascular disease is universally accessible in urban areas, supported by new health technology developments. The Cities@Heart project aims to reduce the economic burden of cardiovascular disease on society and improve quality-of-life and life expectancy for millions.

Birmingham joins £50m MRC Centre for clinical trial innovation

Written by Louise Stanley on . Posted in Clinical trials, Experimental medicine.

Academics at BHP founder-member the University of Birmingham will be part of a new Medical Research Council Centre of Research Excellence in Clinical Trial Innovation (MRC CoRE) which aims to speed up patient and participant access to new medicines and trials, for improved patient care.

The Centre, in partnership with the National Institute for Health and Care Research (NIHR), will receive up to £50 million over 14 years to transform the landscape of clinical trials – shaking up approaches to trial design and delivery by developing pioneering new ways to accelerate processes and drive improvements in treatment and recovery.

The University of Birmingham will be one of six leading research intensive institutions to join forces to support MRC CoRE, with Professor Thomas Pinkney bringing his expertise in running complex surgical clinical trials including the ROSSINI-Platform trial, the UK’s largest ever surgical trial to make future operations safer.

MRC CoRE will see UK trials move away from the current approach of testing a single intervention in a single disease one at a time. Finding efficient way to test multiple drugs in multiple diseases at the same time would be a game changer both for industry and the academic community.

Professor Pinkney said: “This new funding will give a major boost to the latent potential around the UK to design and run clinical trials for new treatments for participants and patients.

“Birmingham brings a huge breadth of clinical trials experience both here in the UK and around the world, including surgical trials, complex cancer trials including with children, and many more besides. In addition, the West Midlands offers a unique opportunity with clinical trials for working with a diverse population and socioeconomic background, and so we are ideally placed to help accelerate the development of medicines for patients.”

Professor Patrick Chinnery, Medical Research Council Executive Chair explained: “The UK medical research community is very effective at gaining insights about disease biology and developing potential new treatments and interventions, especially in underserved areas such as multiple long-term conditions and rare diseases.

“It is essential to quickly move such interventions forward to the right patients, at the right doses, durations and combinations.”

Leading the world in innovative trial design

A key area of focus are clinical trials aimed at identifying the minimum ‘intensity’ – such as duration, frequency, or dose required – for a drug to be effective. For instance, finding the lowest effective dose of a chemotherapy drug could help make cancer treatment gentler for patients by reducing side effects.

The MRC CoRE team will be led by Professor Max Parmar will build on the team’s past work which created the highly innovative ‘multi-arm multi-stage’ platform clinical trials. These designs have revolutionised clinical trials to be more flexible, able to add or remove new drugs for testing over time, depending on results and new breakthroughs.

The leadership group will include researchers from the University College London, London School of Hygiene & Tropical Medicine, University of Cambridge, University of Edinburgh, University of Birmingham, and Newcastle University.

Professor Max Parmar, Director of the MRC CoRE in Clinical Trial Innovation, said: “Basic science is rapidly producing more understanding of biology and consequently many new interventions to help us in a range of diseases – both by industry and academic routes. Clinical trials are the way in which we evaluate all these new treatments. However, they are too slow and costly meaning it takes some 20 years to get a new invention from the laboratory into routine clinical practice at a cost of some £2 billion. Our goal with this CoRE is to substantially reduce this time so that patients can benefit much sooner from new treatments and also bring the costs of testing new treatments down.”

Professor Lucy Chappell, Chief Scientific Adviser at the Department of Health and Social Care and Chief Executive Officer of the NIHR, said: “Success for this Centre will be having efficient adaptive trials becoming part of the mainstream, in the range of approaches to carrying out clinical trials. With increasingly complex interventions being developed for our diverse population, we’re excited for the UK to be taking a leadership role in innovative trial design and look forward to seeing effective and more targeted treatment regimes being evaluated at pace and informed by novel methodology approaches.”