What Happens in the Follow-Up Phase?

The follow-up portion of the study is looking for environmental factors that may be important in the development of type 1 diabetes. The study involves having the parents record information about the child as the child is growing up, time of food introduction, illnesses, medications, vitamins, allergic reactions, social and psychological factors. We give the parents a book called the TEDDY Book where they can write everything down.
Clinic Visits
Stool Samples
Diet

Learn more about follow-up by watching the TEDDY video! Click here to watch.

Clinic Visits

Clinic visits occur 4 times a year until the child is 4 years old and then twice a year after that. At the clinic visits, the clinic staff will review the TEDDY book with the parents and extract the pertinent information, interviews will be done, the child will be measured and weighed, and blood tests will be performed. The blood is tested for certain antibodies that might mean that diabetes is starting to develop.

A number of recent studies have shown that patients with type 1 diabetes have antibodies to insulin and insulin producing cells, known as autoantibodies. This is consistent with the theory that type 1 diabetes is an autoimmune disease and that autoantibody production is an early step in the development of the disease. Autoantibodies can be detected in many cases before diabetes happens, and the presence of autoantibodies has been shown to be a strong predictive marker for eventually getting type 1 diabetes.
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Stool Samples

Stool samples are sent by the parents in the mail once a month until the child is four and twice a year after that to test for gastrointestinal viruses. We are asking parents to collect stool samples so often because stomach viruses pass through the system quickly. Testing often will allow for us to catch possible exposure to viruses such as enteroviruses and rotovirus. Frequent testing also makes it easier to pinpoint if viral infection occurs close to the time that autoantibodies first appear.
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Diet

Diet is also looked at very closely in the TEDDY study. We use a computer program called NDS to gather detailed information about the child's diet. At the three month clinic visit a 24 hour diet recall is completed with the parents. For following visits, parents are asked to keep a log of what their child ate for 3 days prior to the clinic visit and then we go over this log with them during the visit.
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