Early Identification of Type 1 Diabetes: Who Might Benefit from Screening for Autoantibodies?

Learning Objectives

• Explore the benefits associated with screening for islet autoantibodies
• Understand that anyone can develop autoimmune T1D, but factors including a family history of the disease can increase the risk
• Explain the rationale for selection of individuals for islet autoantibody screening, as well as the rationale for general population screening

Summary

Identification and monitoring of autoimmune type 1 diabetes can reduce the risk of diabetic ketoacidosis at clinical diagnosis and allow individuals and their families or caregivers time to prepare for future disease management. General-population screening, using combinations of genetic and autoantibody testing has proved effective in identifying individuals who may have autoimmune type 1 diabetes. T1D screening was associated with a lower risk of DKA at diagnosis, compared to individuals who were not screened.

Genetic risk for type 1 diabetes can be inferred through family history. Having a first-degree relative with the disease confers a 10-to-15-fold higher risk versus the general population. Calculation of genetic risk scores can aid the selection of individuals in the general population who are at increased risk of autoimmune type 1 diabetes for islet autoantibody screening.

However, it should be remembered that around 90% of people diagnosed with type 1 diabetes have no family history of the disease. An increased risk of developing type 1 diabetes has also been noted in people with a personal or family history of other autoimmune disorders, for example celiac disease, autoimmune thyroid disease, and adrenal disease.

General-population screening, using combinations of genetic and autoantibody testing, can identify individuals who may have autoimmune type 1 diabetes. Candidates for autoantibody screening may also be selected based on individual and family history.

MAT-GLB-2405111-1.0 08/2024