We wish to thank Dr Ross for her interest in our study. We absolutely agree that newborn screening for genetic risk for type 1 diabetes mellitus should not be offered as a part of general screening programs before safe and effective preventive measures have been developed. However, in carefully constructed research framework with appropriate counseling facilities and close follow-up schedules, the situation is very different.
The existing data indicate that parental anxiety is not significantly elevated after receiving the risk information and seems to further dissipate over time 1- 4; however, there is considerable variation depending on the ethnic background and education level of the parents, for example.1 In the extremely ethnically homogeneous and uniformly well-educated Finnish population, which is the target in the Type 1 Diabetes Prediction and Prevention study, these problems are probably smaller than in many other countries. However, the worry about at least transient psychological and emotional untoward effects is real and well recognized by researchers. Unrelated negative life experiences and stress will play a role in the psychological impact of the risk information, and it is extremely important to learn to recognize families who need special attention and to develop tools for supportive measures. These aspects are actively monitored and investigated in the Type 1 Diabetes Prediction and Prevention Project as well as in other type 1 diabetes mellitus natural history and prevention study protocols that share the same approach. Every effort is taken to find ways to minimize the burden on the family.