New Publication Alert!
Breakthrough T1D spearheaded a paper titled “International consensus guidance for general population screening for islet autoantibodies to diagnose early-stage type 1 diabetes” that was published in Diabetologia. This is an important step toward integrating general population screening for type 1 diabetes (T1D) into clinical practice globally. Read on to learn more about why this is important, what experts think this should look like, and what it means for you and your family.
Early Detection, Screening, and Islet Autoantibodies
Early detection of T1D means detecting the disease before symptoms appear or insulin therapy is needed. This is done through screening blood samples to detect the presence of islet autoantibodies, which signal that the body’s immune system is attacking insulin-producing cells. If a person has two or more persistent autoantibodies, they are in stage 1 or 2 T1D, and it’s very likely they’ll develop clinical, stage 3 T1D.
Making the Case for General Population T1D Screening
In 2024, Breakthrough T1D led the way with the publication of Consensus Guidance for Monitoring Persons with Islet Autoantibody-Positive Pre-Stage 3 Type 1 Diabetes, which lays out what clinicians should do when T1D autoantibodies are detected. But it does not touch on the bigger question: who should get screened?
There is an urgent need for population-level screening because:
- Global T1D incidence is increasing.
- Early detection has substantial benefits.
- Most T1D diagnoses occur in people without any family history of the disease.
- Evidence from ongoing, large-scale studies around the globe has shown that we have a screening method that works.
Benefits of Early Detection
- Reduced risk of diabetic ketoacidosis (DKA) at diagnosis
- Option to intervene with the approved therapy Tzield (teplizumab)
- Increased eligibility for participating in disease-modifying therapy (DMT) clinical trials
- Increased early control of hyperglycemia that can reduce the risk of complications
- Time to plan, prepare, and empower educated decision-making
Breakthrough T1D convened a group of nearly 30 international experts to establish consensus that can act as a clinical roadmap to make general population screening a reality.
Key Recommendations for Clinical Adoption of General Population T1D Screening
So, who should get screened? Experts recommend that T1D screening begin in young children aged 2-4 years, with rescreening of children who test negative at ages 4-6 years and again at 10-15 years, aligned with other preventative healthcare visits. Every initial screening result should be confirmed with another test before diagnosis.
This may seem simple enough, but integrating screening into established clinical workflows will require collective effort. Healthcare systems must be fully prepared to deliver the entire screening, monitoring, and referral pathway before widespread integration. Policy and infrastructure must be in place, including established processes for confirming test results, education and monitoring of people with early-stage T1D, and referring people to specialists. In addition, healthcare professionals (HCPs) will need to effectively communicate with and provide psychosocial support to families at every step of the screening process.
The bottom line is that integrating general population T1D screening into clinics will require extensive cooperation across diverse medical settings to become a reality. But the payoff is clear: combined with Tzield and other emerging DMTs, general population screening should open the door to delaying—and eventually preventing—the onset of clinical, stage 3 T1D.
What this Means for You and Your Family
Right now, children and adults with or without a family history of T1D can participate in screening through free, research-based programs like TrialNet and ASK. Screening can be done in-person at certain locations, or screening kits can be sent straight to your home.
Based on the consensus guidance, families may consider starting to screen their children as early as ages 2-4. If the screening test detects autoantibodies, there are now concrete next steps that families can discuss with their physicians. You don’t have to wait until general population screening is integrated into clinics to take advantage of it.
Screening and Early Detection are Key to Breakthrough T1D’s Mission
General population T1D screening is a key part of our mission strategy, and more people screening means more people experiencing the benefits of early detection. To screen as many people as possible, clinicians need guidance—and this publication provides just that. We now have concrete recommendations for who to screen for T1D and when. Even more, this consensus has been signed off by almost every single one of our peer institutions, amounting to 20 global diabetes societies and organizations.
This publication is bringing conversations around general population T1D screening to the forefront. Breakthrough T1D is committed to expanding T1D early detection on a global scale, and widespread screening is one of our top priorities. We are mobilizing our resources, knowledge, and partnerships to make this a reality sooner so that more families around the world can benefit.
