7 Screening for type 1 diabetes

To be able to prevent type 1 diabetes, we need to identify individuals with increased risk for developing the disease. To do this, some kind of screening is necessary. The screening may be based on the presence of auto antibodies, a genetic high-risk profile or a combination of these two. Since 2015, the FR1DA-study in Munich, Germany has screened more than 150 000 infants, in order to identify those that have developed auto antibodies. Even without any available prevention, they report benefit from the screening, because hardly no children develop diabetic ketoacidosis and because the families are very well prepared before the onset of the disease, and therefore are better capable to handle the challenges that follow the diagnosis. The Global Platform for the Prevention of Autoimmune Diabetes (GPPAD), launched in 2015, test children for increased genetic risk of developing T1D, and so far, approximately 500 000 have been tested. In Italy, the senate has decided that all children have the right to be tested for celiac and diabetes antibodies from the year of 2024. There are initiatives in many countries, with the aim of launching different kind of screening program, mostly for the purpose of research. Hopefully the results of teplizumab (see above) will be confirmed and further developed in larger studies, to make it possible to predict responders and non-responders. If so, and if other secondary preventions become available, screening for auto antibodies may become justifiable also as a part of standard health care of infants and children.