Beyond Pediatrics: Advancing Early Detection in Adult-Onset Type 1 Diabetes Grant

Breakthrough T1D is offering grants to enhance early detection of adult-onset Type 1 Diabetes (T1D). The initiative aims to address critical knowledge gaps, including improving diagnostic accuracy, understanding immune activation patterns, and addressing misdiagnosis. Grants of up to $900,000 will be awarded to eligible organizations, including non-profits and for-profits, for research that can lead to better outcomes for adults affected by T1D.

Beyond Pediatrics: Advancing Early Detection in Adult-Onset Type 1 Diabetes
Summary
The main goal of this funding opportunity is to improve adult diagnosis of type 1 diabetes (T1D), with special emphasis on the early stages of the disease.This request for application (RFA) will award grants to non-profit and for-profit entities such as academic institutions and industry partners of up to $900,000.00 each and up to 3 years.
Background
During a past Breakthrough T1D-hosted workshop, experts identified key knowledge gaps in adult-onset T1D 7, including the need to reduce ethnic disparities, extend longitudinal screening studies (of genetically high-risk and autoantibody-positive individuals) into adulthood, evaluate disease-modifying therapies given their greater efficacy in children, address challenges in misdiagnosis, assess the benefit and risks of adjunctive therapies, and strengthen post-diagnosis education, psychosocial support and long-term care.
We encourage research proposals that address one or more of the following areas, including but not limited to:
Immune Activation and Autoimmunity: The autoimmune process in adult-onset T1D appears to exhibit distinct patterns of immune activation compared to pediatric cases, including differences in immune cell subsets, cytokine profiles, and the timing and magnitude of the immune response. Proposed studies should aim to characterize these adult-specific immune signatures and investigate their relationship to clinical progression, treatment requirements, and therapeutic responsiveness. Research should leverage established datasets and biobanks with adult-onset T1D cohorts to validate findings across diverse populations. These efforts will be critical to informing the design and timing of disease-modifying therapies targeted at the early stages of T1D in adults.Islet Pathology and Beta Cell Function: Adults diagnosed with T1D often retain greater residual beta cell function at onset than children, suggesting slower disease progression and potential differences in islet pathology. Research should explore the mechanisms underlying these differences, including the pace of beta cell destruction and the regenerative capacity of the adult human pancreas, with implications for therapeutic timing and response.Autoantibodies and Biomarker Validation: In early-stage T1D, adults are more likely to test positive for GADA, while children more commonly exhibit IAA, IA-2A, or ZnT8A. We are seeking proposals that aim to better characterize and validate alternative autoantibodies and other established biomarkers of disease progression through Stages 1 to 3 in adults, with the goal of improving diagnostic accuracy and stratification of progression, including adults with slow disease progression.Accuracy in Misdiagnosis and Diagnostic Tools: We support proposals that aim to address the misdiagnosis of adult-onset T1D, including efforts to distinguish it from T2D through the integration of autoantibodies, C-peptide, and clinical features. Proposals may also include the analysis of existing electronic health record (EHR) data to identify diagnostic patterns and improve classification strategies.Epidemiology Studies: Evidence suggests that while a family history of T1D increases risk at all ages, the strength of this association appears to be greater in childhood-onset cases. This RFA welcomes studies that aim to advance our understanding of the epidemiology of adult-onset T1D using existing databases, as this area remains poorly defined. Projects examining incidence, prevalence, and age-related trends are encouraged to help clarify population-level risk factors

Eligibility

Applications may be submitted by domestic and foreign non-for-profit organizations, public and private, such as universities, colleges, hospitals and laboratories, units of state and local governments, and eligible agencies of the federal government. Applicants must hold an M.D., D.M.D., D.V.M., Ph.D., or equivalent and have a faculty position or equivalent at a college, university, medical school, or other research facility.For-profit entities, or industry collaborations with academia, are welcomed to submit applications in response to this RFA. Please contact the Breakthrough T1D scientific contact below prior to submitting the application. Additional information will be requested from for-profit entities if invited to submit a full proposal.For clinical studies, applicants must hold an appointment or joint appointment in a subspecialty of clinical medicine and conduct human clinical research.There are no citizenship requirements for this program. To assure continued excellence and diversity among applicants and awardees, Breakthrough T1D welcomes applications from all qualified individuals and encourages applications from persons with disabilities, women, and members of minority groups underrepresented in the sciences.