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The First Selective Screening for Type 1 Diabetes in a Pediatric Population in Bulgaria
Natasha Yaneva1,2, Meri Petrova3, Adelina Yordanova3
1Clinic for Pediatric Endocrinology, Diabetes and Metabolic Diseases, University Children's Hospital "Prof. Ivan Mitev", 1606 Sofia, Bulgaria.
Journal of Clinical Medicine
|May 4, 2026
Summary
This pilot study demonstrates the feasibility of type 1 diabetes (T1D) screening in Bulgaria, identifying islet autoantibodies in 4.4% of high-risk children. The findings support a scalable model for early T1D detection to reduce healthcare burdens.
Area of Science:
- Endocrinology
- Immunology
- Pediatrics
Background:
- Type 1 diabetes (T1D) incidence is rising globally, including in Bulgaria.
- Presymptomatic T1D screening reduces diabetic ketoacidosis (DKA) risk and enables early intervention.
- Limited T1D screening initiatives exist in Bulgaria.
Purpose of the Study:
- Evaluate the feasibility of selective T1D screening in Bulgarian children.
- Identify potential clinical associations with islet autoimmunity in screened children.
- Establish a framework for future longitudinal T1D research in Bulgaria.
Main Methods:
- Pilot study involving 210 children (0-18 years), with 160 having a family history of T1D.
- Screening for multiple islet autoantibodies (AABs) using chemiluminescence immunoassay (CLIA).
- Longitudinal follow-up planned for autoantibody-positive participants.
Main Results:
- Recruitment reached 84% of the target, confirming feasibility.
- Seven high-risk children (4.4%) tested positive for a single autoantibody (GADA, ZnT8A, IA-2A, IAA).
- No multiple autoantibody positivity, T1D, or significant clinical associations were found in this exploratory phase.
Conclusions:
- Selective T1D screening is feasible in Bulgaria, supported by public interest.
- The study provides a roadmap for larger, longitudinal research on T1D autoimmunity.
- A scalable model for early T1D detection can reduce national healthcare system burden.
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