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Screening Children for Early-Stage Type 1 Diabetes

Christiane Winkler1,2, Nadine Friedl1, Renate Abt3

  • 1Institute of Diabetes Research, Helmholtz Munich, German Research Center for Environmental Health, Munich, Germany.

JAMA
|May 21, 2026
PubMed

Insights

Population screening in children identified early-stage type 1 diabetes (T1D). Progression to clinical T1D occurred similarly in children with and without a family history, informing future therapy trials.

Area of Science:

  • Pediatric Endocrinology
  • Autoimmune Diseases
  • Public Health Screening

Background:

  • Early detection of type 1 diabetes (T1D) is crucial for interventions aimed at delaying disease onset.
  • Population-based screening studies are essential for understanding the prevalence and progression of T1D in children.

Purpose of the Study:

  • To estimate the prevalence of early-stage (stages 1-2) type 1 diabetes in children.
  • To assess the progression rate from early-stage to clinical (stage 3) T1D.
  • To evaluate the impact of family history on T1D progression.

Main Methods:

  • A population-based screening study in Bavaria, Germany, involving over 220,000 children aged 1.75 to 10.99 years.
  • Screening involved measuring islet autoantibodies to identify presymptomatic T1D.
  • Longitudinal monitoring in specialized centers for children diagnosed with early-stage T1D.

Main Results:

  • The adjusted population frequency of early-stage T1D was 0.3%, with 0.23% for stage 1 and 0.06% for stage 2.
  • Five-year progression from early-stage to clinical T1D was 36.2% (annualized rate 9.6%).
  • Progression rates did not significantly differ between children with and without a first-degree family history of T1D.

Conclusions:

  • General population screening effectively identifies children with early-stage T1D.
  • The findings support considering screening beyond genetically selected populations.
  • Results provide valuable data for designing disease-modifying therapy trials for T1D.
Abstract

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