Sanford Health expands PLEDGE Study to several clinics in Bemidji region

Provides type 1 diabetes and celiac disease screening for children


September 28, 2023

BEMIDJI, Minn. — Sanford Health, the largest rural health system in the country, has expanded its PLEDGE Study to clinics in the Bemidji region. PLEDGE centers on a blood test to identify children at risk of developing type 1 diabetes (T1D) and celiac disease and is integrated into routine pediatric care at Sanford clinics.

“The goal of the PLEDGE study is to be able to catch those children who are on the path towards type 1 diabetes (T1D) so that we can prevent diabetic ketoacidosis (DKA) — a life-threatening condition that has often developed by the time T1D is first recognized in a child,” said Dr. Kurt Griffin, principal investigator of the PLEDGE Study and the Todd and Linda Broin Chair of the Sanford Project. “Children with T1D who are treated with insulin early enough to prevent DKA have better blood sugar levels for years afterwards. We expect results from PLEDGE will help support inclusion of these tests among those that are standard for all children.”

Children found to have markers related to T1D through the PLEDGE Study are offered education, ongoing monitoring, and appropriate early intervention to prevent serious illness at the time of diagnosis. When applicable, Sanford will also offer participation in clinical trials seeking to delay or stop the progression to clinical T1D.

Children with markers of celiac disease are referred to pediatric gastroenterologists for treatment.

Since its launch two years ago, the PLEDGE Study has expanded to 150 clinics across Sanford’s footprint in the Dakotas, Minnesota, Iowa, and Nebraska. More than 6,000 patients have signed up for PLEDGE. To date, close to 30 patients with persistent T1D antibodies have been identified and are undergoing periodic monitoring.

The Leona M. and Harry B. Helmsley Charitable Trust recently made a $3.4 million gift which supports continued screening to identify children at risk of developing T1D or celiac disease. The Helmsley Charitable Trust made an initial $1.3 million grant when the PLEDGE (Population Level Estimate of type 1 Diabetes risk Genes in children) Study first launched in 2020.

In T1D, the immune system makes antibodies that destroy the cells in the pancreas that produce insulin, which the body uses to turn food into energy. Some of the genetic risk factors for T1D are shared with celiac disease, in which eating foods containing gluten triggers the immune system, causing inflammation in the small intestine.

Children with celiac disease start with few, if any, symptoms, and progress to more typical gastrointestinal issues. Left untreated, more serious complications can develop including impacts on growth and physical development.

Parents can enroll their children in the study if their child:

• Is between the ages of 0-5 or 9-16 years

• Has not been diagnosed with clinical T1D

• Receives routine care at Sanford Health

• Has a Sanford MyChart account

Children ages 6-17 who have a sibling with T1D or T1D antibodies may also join the study.

To learn more or to enroll in PLEDGE, talk with your child’s primary care physician or visit

About Sanford Health

Sanford Health, the largest rural health system in the United States, is dedicated to transforming the health care experience and providing access to world-class health care in America’s heartland. Headquartered in Sioux Falls, South Dakota, the organization serves more than one million patients and 220,000 health plan members across 250,000 square miles. The integrated health system has 47 medical centers, 2,800 Sanford physicians and advanced practice providers, 170 clinical investigators and research scientists, more than 200 Good Samaritan Society senior care locations and world clinics in 8 countries around the globe. Learn more about Sanford Health's commitment to shaping the future of rural health care across the lifespan at or Sanford Health News.


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