<h2 style="text-align:center;">Watch the film here</h2>

Step into The Betaverse and uncover the hidden world of beta cells.
 
 The film explores the mechanisms of autoimmune type 1 diabetes (T1D) and brings to life the crucial role of beta cells in maintaining glucose homeostasis.
 
 Learn more about these cells that not only produce insulin but also keep the entire system in harmony.

OUT-OF-TAXONOMY

DISCOVER THE STORY INSIDE THE PANCREAS

Step into The Betaverse and uncover the hidden world of beta cells.

  The film explores the mechanisms of autoimmune type 1 diabetes (T1D) and brings to life the crucial role of beta cells in maintaining glucose homeostasis.

  Learn more about these cells that not only produce insulin but also keep the entire system in harmony.

<h2>Key takeaway</h2>

<h3>Can autoimmune T1D predispose patients to psychological issues?</h3>
Symptomatic autoimmune T1D requires life-long insulin therapy.3 Insulin regimens in T1D are often intensive, comprising multiple daily injections or insulin pump therapy.4&nbsp;
Self-management by the patient forms the basis of diabetes care, which can be psychologically demanding.&nbsp;Besides the insulin administration,&nbsp;living with T1D involves constant blood glucose monitoring, dietary and lifestyle restrictions, and consideration of physical activity levels. These daily self-management tasks, along with worries for the future, can lead to psychological and behavioral reactions in patients.3,5
Factors causing psychological and behavioral reactions in patients with T1D5

<h3>What are the common psychological issues in patients with T1D?</h3>
A patient self-reported international survey revealed that patients with diabetes experience various forms of emotional distress as part of the psychosocial burden of living with the condition.6 The most common issues reported were anxiety, depression, fear of low blood sugars, low mood, and diabetes-related distress.6&nbsp;

Among patients with T1D, the prevalence of diabetes distress ranges from 22% to 42%, with a nine-month incidence as high as 54%.1 The distress is also associated with a reduced health-related quality of life.1 Sleep disturbances are also prevalent, with 30% to 50% of patients with T1D experiencing poor sleep, and over 50% meeting criteria for moderate to severe obstructive sleep apnea.1 Other common mental health disorders associated with autoimmune T1D include eating, personality and behavioral disorders.8,9
Psychological disorders in autoimmune T1D6,8,9

<h3>How can psychological issues impact diabetes self-management?</h3>
Psychosocial issues impact glycemic outcomes by increasing HbA1c, and may also result in increased blood pressure, cholesterol levels, microvascular, and macrovascular complications in patients with T1D. Additionally, they can lead to reduced self-care behaviors, comorbid psychosocial issues, decreased quality of life and increased mortality.1
Anxiety and depression can negatively impact T1D management. Anxiety may cause emotional distress, fear of hypoglycemia, and less frequent glucose monitoring by negatively impacting adherence to therapy, which in turn can affect glycemic control. Depressive symptoms can also negatively impact glycemic control by reducing motivation to adhere with prescribed therapies and perform regular glucose monitoring.4

<h3>What can be the psychological impact of T1D in families and caregivers?</h3>
The psychological impact of T1D can sometimes be greater on family members than on patients.10 Parents of children with T1D face overwhelming challenges, including constant worry about hypoglycemia or hyperglycemia, and responsibility for their child’s health.11
Psychological impact of T1D on family and caregivers11,12&nbsp;

Parents, especially mothers, of children with newly diagnosed T1D are at a higher risk of being diagnosed with post-traumatic stress disorder (PTSD).13 Higher parental depression and anxiety are linked to decreased monitoring, lower self-efficacy, and challenges in learning diabetes management, contributing to suboptimal T1D care.11

<h3>What are the psychological concerns with a late-stage T1D diagnosis?</h3>
T1D is a continuum and can be identified at the presymptomatic stage.16
<a href="https://pro.campus.sanofi/global/t1d/articles/can-autoimmune-type-1-diabetes-be-detected-years-before-symptom-onset">Learn&nbsp;how autoimmune T1D can be detected years before symptom onset</a>.
A delay in the diagnosis of autoimmune T1D increases the risk of DKA at diagnosis, a severe and potentially life-threatening complication, which can result in persistent challenges in glycemic control and recurrent episodes of DKA.2,17,18&nbsp;
Patients experiencing recurrent episodes of DKA exhibit higher levels of anxiety, depression, and diabetes distress, along with increased challenges in emotion regulation and personality dysfunction.19,20 A case-controlled study found that over 60% of these patients had a diagnosed mental health disorder.19&nbsp;
The psychological impact of DKA extends beyond immediate health concerns. It is&nbsp;also associated with suicidal or self-injurious behaviors, with one study reporting an 11-times higher suicide rate in patients with T1D compared with that in the general population.21&nbsp;In children, DKA has been linked to poorer neurodevelopmental outcomes, including lower IQ.21
<a href="https://pro.campus.sanofi/t1d/articles/early-detection-of-autoimmune-type-1-diabetes-could-reduce-the-risk-of-diabetic-ketoacidosis">Learn how early detection of autoimmune T1D could reduce the risk of diabetic ketoacidosis</a>.

<h3>Can screening results have a psychosocial impact on patients and their families?</h3>
Patients who screen positive for T1D-related autoantibodies and their families may experience significant stress along with a myriad of emotional and behavioral reactions in response to this life-altering news.22 Despite these challenges, early screening results in better long-term outcomes.23
Thus, psychosocial support should be provided to both patients and their families with the aim of supporting them in successfully managing the psychosocial impact.22
<a href="https://pro.campus.sanofi/t1d/articles/test-for-autoantibodies">Learn more about screening for autoantibodies to identify individuals at risk for autoimmune T1D</a>.
<h3>Consensus guidance recommendations for psychosocial support for patients identified at risk or at early stage T1D</h3>
<a href="https://diabetesjournals.org/care/article/47/8/1276/156880/Consensus-Guidance-for-Monitoring-Individuals-With">The consensus document for monitoring individuals with single (at-risk) and multiple (early-stage T1D) islet autoantibody positivity</a> provides the following expert clinical advice for psychosocial support:22
<ul>
 <li>Emotional, cognitive and behavioral functioning should be assessed in people at risk or with early-stage T1D and their family members, when appropriate with a specific focus on anxiety, risk perception and behavior changes</li>
 <li>HCPs should initiate psychosocial support to&nbsp;individual at risk or with early-stage T1D and/or their caregivers and family members&nbsp;by inquiring about reactions to the autoantibody diagnosis, using guiding questions and standardized and validated questionnaires</li>
 <li>At each monitoring visit, there should be enquiries into current needs, particularly coping</li>
 <li>Psychological care should be integrated into routine medical visits and, whenever possible, delivered by providers with diabetes-specific training</li>
</ul>
<a href="https://pro.campus.sanofi/t1d/articles/how-should-individuals-with-positive-autoimmune-t1d-autoantibodies-be-monitored-over-time">Learn how should individuals with positive autoimmune T1D autoantibodies be monitored over time</a>.
<h3>What is the importance of psychosocial support in patients with T1D?</h3>
Addressing the emotional and mental health challenges of T1D is crucial for improving overall outcomes.24&nbsp;However, the current clinical care falls short of adequately addressing the psychosocial needs of those living with the condition. The lack of attention to psychosocial issues creates a barrier to achieving optimal diabetes self-management.6 However, a comprehensive psychological support in autoimmune T1D can significantly improve both mental and physical health outcomes.4,25

References
<ol>
 <li>American Diabetes Association (ADA) Professional Practice Committee; 5. Facilitating positive health behaviors and well-being to improve health outcomes: Standards of care in diabetes—2024. Diabetes Care. 2024; 47 (Supplement_1): S77–S110. doi.org/10.2337/dc24-S005.</li>
 <li>Cherubini V, Grimsmann JM, Åkesson K, et al. Temporal trends in diabetic ketoacidosis at diagnosis of paediatric type 1 diabetes between 2006 and 2016: Results from 13 countries in three continents. Diabetologia. 2020;63(8):1530–1541. doi:10.1007/s00125-020-05152-1</li>
 <li>Benton M, Cleal B, Prina M, et al. Prevalence of mental disorders in people living with type 1 diabetes: A systematic literature review and meta-analysis. Gen Hosp Psychiatry. 2023;80:1–16. doi: 10.1016/j.genhosppsych.2022.11.004.</li>
 <li>Bombaci B, Torre A, Longo A, et al.&nbsp;Psychological and clinical challenges in the management of type 1 diabetes during adolescence: A narrative review. Children (Basel). 2024;11(9):1085. doi: 10.3390/children11091085.</li>
 <li>Formánek T, Chen D, Šumník Z, et al. Childhood-onset type 1 diabetes and subsequent adult psychiatric disorders: A nationwide cohort and genome-wide Mendelian randomization study. Nat Ment Health. 2024;2(9):1062–1070. doi:10.1038/s44220-024-00280-8.</li>
 <li>Kelly RC, Holt RIG, Desborough L, et al. The psychosocial burdens of living with diabetes. Diabet Med. 2024;41(3):e15219. doi: 10.1111/dme.15219.</li>
 <li>van Duinkerken E, Snoek FJ, de Wit M. The cognitive and psychological effects of living with type 1 diabetes: A narrative review. Diabet Med. 2020;37(4):555–563. doi:10.1111/dme.14216.</li>
 <li>Cooper MN, Lin A, Alvares GA, de Klerk NH, Jones TW, Davis EA. Psychiatric disorders during early adulthood in those with childhood onset type 1 diabetes: Rates and clinical risk factors from population-based follow-up. Pediatr Diabetes. 2017;18(7):599–606. doi:10.1111/pedi.12469.</li>
 <li>Lunkenheimer F, Eckert AJ, Hilgard D, et al.&nbsp;Posttraumatic stress disorder and diabetes-related outcomes in patients with type 1 diabetes. Sci Rep. 2023;13(1):1556. doi: 10.1038/s41598-023-28373-x.</li>
 <li>Allen V, Mahieu A, Kasireddy E, et al.&nbsp;Humanistic burden of pediatric type 1 diabetes on children and informal caregivers: Systematic literature reviews. Diabetol Metab Syndr. 2024;16(1):73. doi: 10.1186/s13098-024-01310-2.</li>
 <li>Whittemore R, Jaser S, Chao A, Jang M, Grey M. Psychological experience of parents of children with type 1 diabetes: A systematic mixed-studies review. Diabetes Educ. 2012;38(4):562–579. doi:10.1177/0145721712445216.</li>
 <li>Pons Perez S, Robinson H, Brophy C, Warner JT. Impact of a new diagnosis of childhood type 1 diabetes on parents’ sleep and employment. Oral presentation 21. Presented at: The International Society for Pediatric and Adolescent Diabetes (ISPAD) 2024 Annual Conference; October 17, 2024; Lisbon, Portugal.</li>
 <li>Rechenberg K, Grey M, Sadler L. Stress and posttraumatic stress in mothers of children with type 1 diabetes. J Fam Nurs. 2017;23(2):201–225. doi:10.1177/1074840716687543.</li>
 <li>De Sousa B, Nogueira Machado S, Delgado L, Meireles C, Dias Â. Parental burnout associated with type 1 diabetes - preliminary results. Poster 125. Presented at: The International Society for Pediatric and Adolescent Diabetes (ISPAD) 2024 Annual Conference; October 17, 2024; Lisbon, Portugal.</li>
 <li>Kingsley O, Bebbington K, Naragon-Gainey K. Understanding the impacts of parental anxiety in the context of caring for a young child with type 1 diabetes: a qualitative study. Poster 205. Presented at: The International Society for Pediatric and Adolescent Diabetes (ISPAD) 2024 Annual Conference; October 18, 2024; Lisbon, Portugal.</li>
 <li>Insel RA, Dunne JL, Atkinson MA, et al. Staging presymptomatic type 1 diabetes: A scientific statement of JDRF, the Endocrine Society, and the American Diabetes Association. Diabetes Care. 2015;38(10):1964–1974. doi:10.2337/dc15-1419.</li>
 <li>Edelman S, Holyoke K, Symowicz J, Rinehart L, Gordon S. Preventing and managing diabetic ketoacidosis in people with T1D.&nbsp;<a href="https://www.breakthrought1d.org/wp-content/uploads/2020/06/JDRF_Ebrief-5_DKA.pdf">https://www.breakthrought1d.org/wp-content/uploads/2020/06/JDRF_Ebrief-5_DKA.pdf</a>. </li>
 <li>Sims EK, Besser REJ, Dayan C, et al.&nbsp;Screening for type 1 diabetes in the general population: A status report and perspective. Diabetes. 2022;71(4):610–623.&nbsp;doi:10.2337/dbi20-0054</li>
 <li>Hamblin PS, Abdul-Wahab AL, Xu SFB, Steele CE, Vogrin S. Diabetic ketoacidosis: A canary in the mine for mental health disorders?. Intern Med J. 2022;52(6):1002–1008. doi:10.1111/imj.15214</li>
 <li>Garrett CJ, Moulton CD, Choudhary P, Amiel SA, Fonagy P, Ismail K. The psychopathology of recurrent diabetic ketoacidosis: A case-control study. Diabet Med. 2021;38(7):e14505. doi: 10.1111/dme.14505.</li>
 <li>Al Alshaikh L, Doherty AM. The relationship between diabetic ketoacidosis and suicidal or self-injurious behaviour: A systematic review. J Clin Transl Endocrinol. 2023;34:100325. doi: 10.1016/j.jcte.2023.100325.</li>
 <li>Phillip M, Achenbach P, Addala A, et al. Consensus guidance for monitoring individuals with islet autoantibody-positive pre-stage 3 type 1 diabetes. Diabetes Care. 2024;47(8):1276–1298.&nbsp;doi:10.2337/dci24-0042.</li>
 <li>Elding Larsson H, Vehik K, Bell R, et al. Reduced prevalence of diabetic ketoacidosis at diagnosis of type 1 diabetes in young children participating in longitudinal follow-up. Diabetes Care. 2011;34(11):2347–52. doi: 10.2337/dc11-1026.</li>
 <li>Kalra S, Jena BN, Yeravdekar R. Emotional and psychological needs of people with diabetes. Indian J Endocrinol Metab. 2018;22(5):696–704. doi:10.4103/ijem.IJEM_579_17.</li>
 <li>Małachowska M, Gosławska Z, Rusak E, Jarosz-Chobot P. The role and need for psychological support in the treatment of adolescents and young people suffering from type 1 diabetes. Front Psychol. 2023;13:945042. doi: 10.3389/fpsyg.2022.945042.</li>
</ol>

Psychological issues in autoimmune patients with type 1 diabetes (T1D) impact glycemic control, increase the risk of cardiovascular complications, contribute to comorbid psychosocial conditions, and reduce overall quality of life.1 Early screening for genetic risk factors and beta-cell autoantibodies helps prevent severe complications, such as diabetic ketoacidosis (DKA) and ensures timely access to crucial psychosocial support.2

Early identification of autoimmune type 1 diabetes can reduce its psychological impact.

TYPE-1-DIABETES

DIABETES

<h3>Transforming autoimmune T1D care: Why a paradigm shift is crucial?</h3>
Type 1 diabetes (T1D) is an autoimmune condition that destroys pancreatic beta cells, leading to insulin deficiency and long-term insulin dependence. Despite treatment advances, T1D remains challenging, with significant financial, emotional, and medical burdens.3&nbsp;
Globally, millions suffer from autoimmune T1D3. While individuals with a first-degree relative have a 15-fold higher risk, about 85% of newly diagnosed children have no family history.4 Poor glycemic control in youth increases the risk of morbidity and early mortality.3,5
As a greater understanding of pathophysiology of T1D have evolved, research efforts have been devoted to delaying the onset of clinical disease.4&nbsp;

<h3>Stay ahead of the management of autoimmune T1D: How early detection can be a game changer?&nbsp;</h3>
Autoantibodies&nbsp;in the blood can be detected before the onset of clinical symptoms of the disease.6 Hence, identification of islet beta-cell autoantibodies in asymptomatic children can serve as a true diagnostic feature of autoimmune T1D, reflective of a medical condition. By implementing early staging, autoimmune T1D can be recognized initially as an immune disorder. This approach creates an opportunity for therapeutic intervention before the disease advances to a clinical diagnosis.7&nbsp;
Screening for islet beta-cell autoantibodies in high-risk individuals allows for&nbsp;
<ul>
 <li>Diagnosis of early stage autoimmune T1D</li>
 <li>Timely intervention through monitoring and treatment</li>
 <li>Prevention of complications such as DKA.8-9&nbsp;</li>
</ul>
Furthermore, early screening and detection can significantly expedite drug development, enhance academic research, boost public health initiatives aimed at reversing islet beta-cell autoimmunity and halting the progression to symptomatic autoimmune T1D.7
<a href="https://pro.campus.sanofi/t1d/articles/test-for-autoantibodies">Click here</a> to know more about importance of testing for autoantibodies as a method to identify individuals at risk of developing autoimmune T1D.
Benefits of early autoimmune T1D screening4, 9-10

<h3>What is the supporting evidence on screening of autoimmune T1D?</h3>
Previous large-scale screening programs conducted&nbsp;in different countries have already shown the benefits of universal screening, including prevention of hospitalizations for DKA and improvements in long-term glycemic control in patient with autoimmune T1D.11-12&nbsp;
The Autoimmunity Screening for Kids (ASK) study, a large-scale pediatric screening initiative in Colorado (USA) for celiac disease (CeD) and autoimmune T1D, demonstrated that pre-symptomatic autoimmune T1D screening could be cost-effective in regions with a high prevalence of DKA.11&nbsp;
Fr1da study (Bavaria, Germany), has shown that at the time of clinical diagnosis of autoimmune T1D, children with a prior early-stage diagnosis (vs those without) had lower median HbA1c, lower median fasting glucose, and higher median fasting C-peptide. The incidence of ketonuria and DKA was also lower at clinical diagnosis in children with a prior early-stage diagnosis.13
These pilot studies have demonstrated the potential of conducting pediatric screening for autoimmune T1D in the general population. In Italy, these developments have translated into a nationwide health program with the objective of reaching the entire pediatric population.12

<h3>What do the guidelines recommend?</h3>
International guidelines on autoimmune T1D suggests diabetes-related autoantibody screening among individuals with a family history and offered to appropriate candidates within research setting.14 However, consideration for screening the risk of autoimmune T1D in the general population is now growing.4&nbsp;
Recommendations on screening of individuals with risk of autoimmune T1D by various societies1,4,15
<figure class="table" style="width:500px;">
 <table>
 <tbody>
 <tr>
 <td style="background-color:rgb(112, 34, 221);">Society</td>
 <td style="background-color:rgb(112, 34, 221);">Guidance</td>
 </tr>
 <tr>
 <td>American Diabetes Association (ADA)15</td>
 <td>
 <ul>
 <li>“Having multiple confirmed islet autoantibodies is a risk factor for clinical diabetes. Testing* for dysglycemia may be used to further forecast near term risk. When multiple islet autoantibodies are identified, referral to a specialized center for further evaluation and/or consideration of a clinical trial or approved therapy to potentially delay development of clinical diabetes should be considered.”</li>
 <li>“Standardized islet autoantibody tests are recommended for classification of diabetes in adults who have phenotypic risk factors† that overlap with those for T1D.”</li>
 </ul></td>
 </tr>
 <tr>
 <td>The International Society for Pediatric and Adolescent Diabetes (ISPAD)4</td>
 <td>
 <ul>
 <li>“General population screening programs using combinations of genetic and autoantibody testing can identify high-risk children.”</li>
 <li>“Both general population and targeted screening should be coupled with education and monitoring programs for those identified with autoantibodies.”</li>
 </ul></td>
 </tr>
 <tr>
 <td>International consensus developed by Breakthrough T1D (formerly JDRF) and endorsed by ADA and European Association for the Study of Diabetes (EASD)1</td>
 <td>
 <ul>
 <li>“The consensus emphasizes the benefits of early detection of T1D, including reduced risk of DKA at diagnosis, increased planning and preparation time, and the opportunity to consider research aimed at delaying and preventing T1D.”</li>
 </ul></td>
 </tr>
 <tr>
 <td colspan="2">*Screening for presymptomatic T1D may be done by detection of autoantibodies to insulin, glutamic acid decarboxylase (GAD), islet antigen 2 (IA-2), or zinc transporter 8 (ZnT8).&nbsp;†Younger age at diagnosis, unintentional weight loss, ketoacidosis, or short time to insulin treatment.</td>
 </tr>
 </tbody>
 </table>
</figure>

<h3>What are the tools and resources available for screening?</h3>
Globally, various screening programs for autoimmune T1D, designed to identify autoantibodies, are available. These programs vary in their approach.4,16
Screening programs/studies to detect early-stage autoimmune T1D9,17
<figure class="table" style="width:500px;">
 <table>
 <tbody>
 <tr>
 <td style="background-color:rgb(112, 34, 221);">Screening Program</td>
 <td style="background-color:rgb(112, 34, 221);">Population</td>
 <td style="background-color:rgb(112, 34, 221);">Location</td>
 </tr>
 <tr>
 <td colspan="3">Screening of general population&nbsp;</td>
 </tr>
 <tr>
 <td>DIPP</td>
 <td>Age 0.25–15 years with high-risk HLA genotypes</td>
 <td>Finland</td>
 </tr>
 <tr>
 <td>BABY-SCREEN</td>
 <td>
 Newborns to 3 years with high-risk HLA for T1D
 and/or celiac disease</td>
 <td>Finland</td>
 </tr>
 <tr>
 <td>TEDDY</td>
 <td>Age from birth to 15 years</td>
 <td>USA, Germany, Sweden, Finland</td>
 </tr>
 <tr>
 <td>GPPAD</td>
 <td>Infants &lt;1 month of age</td>
 <td>Germany, UK, Poland, Belgium, and Sweden</td>
 </tr>
 <tr>
 <td>PLEDGE</td>
 <td>Age &lt;6 years</td>
 <td>North and South Dakota and Minnesota, USA</td>
 </tr>
 <tr>
 <td>CASCADE</td>
 <td>Age ≥1 year</td>
 <td>Northwest USA</td>
 </tr>
 <tr>
 <td>PRiMeD</td>
 <td>Age 2-16 years</td>
 <td>Virginia, USA</td>
 </tr>
 <tr>
 <td>Fr1da</td>
 <td>Age 1.75–10.99 years</td>
 <td>Germany</td>
 </tr>
 <tr>
 <td>Fr1dolin</td>
 <td>Age 2–6 years</td>
 <td>Germany</td>
 </tr>
 <tr>
 <td>T1Detect (JDRF)</td>
 <td>Age ≥1 year</td>
 <td>Most USA states</td>
 </tr>
 <tr>
 <td>ASK</td>
 <td>Age 1–17 years</td>
 <td>Colorado, USA</td>
 </tr>
 <tr>
 <td colspan="3">Screening of relatives for eligibility to participate in clinical studies</td>
 </tr>
 <tr>
 <td>TrialNet Pathway to Prevention (TN01)</td>
 <td>
 Relatives aged
 3–45 years</td>
 <td>USA, Canada, Europe, Australia</td>
 </tr>
 <tr>
 <td>INNODIA</td>
 <td>
 Relatives and
 general population</td>
 <td>Europe</td>
 </tr>
 <tr>
 <td>Bart’s Oxford (BOX) Family Study</td>
 <td>Relatives</td>
 <td>UK</td>
 </tr>
 <tr>
 <td>Type1Screen</td>
 <td>
 Relatives aged
 2–30 years</td>
 <td>Australia and New Zealand</td>
 </tr>
 <tr>
 <td colspan="3">Screening programs (in development)</td>
 </tr>
 <tr>
 <td>T1Early</td>
 <td>Preschool Age: 3.5-4 years</td>
 <td>UK</td>
 </tr>
 <tr>
 <td>ADIR</td>
 <td>Age 9–18 months and 5 years</td>
 <td>Israel</td>
 </tr>
 <tr>
 <td>JDRF General Population Screening Pilot</td>
 <td>
 Newborns, infants, and
 2–6 years</td>
 <td>Australia</td>
 </tr>
 </tbody>
 </table>
</figure>

<a href="https://www.gettingaheadoftype1.org/resources/provider">Click here</a> to know more about tools and resources that can help in the management of autoimmune T1D.&nbsp;
For more information on the screening and detection of autoimmune T1D, visit the&nbsp;<a href="https://detect-t1d.com/clinician-portal/early-screening-and-detection/">DETECT T1D website</a>.
<h3>How can HCPs become an advocate for autoimmune T1D screening?</h3>
HCPs play a crucial role in advocating for autoimmune T1D screening.14 Here's how they can become effective advocates: 1. Education and awareness:&nbsp;HCPs can explain the risk and benefits of screening to patients and their family members.14
2. Identifying at risk individuals:&nbsp;HCPs can identify high-risk individuals in collaboration with specialists, and either provide a stage-specific intervention or offer clinical trial opportunities.14
3. Advocating for equity in care:&nbsp;It is important for HCPs to continue the advocacy for equal opportunities of screening and monitoring among patients with racial/ethnic or socioeconomic disparities.14
4. Patient communication:&nbsp;HCPs play a crucial role in diabetes education. They can provide accurate information, promote self-management strategies, and work to combat stigma and misinformation.2
5. Fostering collaboration between primary care and specialist HCPs:&nbsp;Primary care HCPs can play a crucial role in screening and monitoring population with early-stage diabetes. Partnership between primary and secondary HCP can help facilitate training and skill development to improve understanding of early stage autoimmune T1D.18
6. Guidelines development:&nbsp;HCP can also support in&nbsp;development of&nbsp; evidence-based screening guidelines to drive&nbsp;paradigm shift in autoimmune T1D care, as early diagnosis has the potential to prevent serious morbidity and mortality.14,18
Autoimmune T1D screening programs are gaining recognition due to the benefits of screening to prevent DKA at late stage of autoimmune T1D diagnosis as well as the availability of therapy to delay the disease progression.18&nbsp;

References
<ol>
 <li>American Diabetes Association Showcases Innovations and Guidance for Early Risk Monitoring of Type 1 Diabetes. Press Release June 24, 2024. Orlando, FL.&nbsp;Available at: https://diabetes.org/newsroom/press-releases/american-diabetes-association-showcases-innovations-and-guidance-early-risk. Accessed: December 2025</li>
 <li>Evans J et al. The essential role of the diabetes educator.&nbsp;Available at: https://diabetesvoice.org/en/caring-for-diabetes/diabetes-educators-and-diabetes-education/. Accessed: December&nbsp;2025</li>
 <li>Owusu BA, Ofori-Boateng P,&nbsp;Bankahet E, et al.&nbsp;A qualitative study of type 1 diabetes complications, mental health, and structural pathways of complications occurrence among young people (14–24 years) and caregivers in southern Ghana. SSM-Mental Health. 2024;6:100368. doi:10.1016/j.ssmmh.2024.100368</li>
 <li>Besser REJ, Bell KJ, Couper JJ, et al.&nbsp;ISPAD Clinical Practice Consensus Guidelines 2022: Stages of type 1 diabetes in children and adolescents. Pediatr Diabetes. 2022;23(8):1175−1187. doi: 10.1111/pedi.13410</li>
 <li>Duca LM, Wang B, Rewers M, et al. Diabetic Ketoacidosis at Diagnosis of Type 1 Diabetes Predicts Poor Long-term Glycemic Control. Diabetes Care. 2017;40(9):1249−1255. doi: 10.2337/dc17-0558</li>
 <li>Al-Mulla, Nizam R, Alqabandi R, Alkandari H, Abubaker J. Early autoantibody screening for type 1 diabetes: a Kuwaiti perspective on the advantages of multiplexing chemiluminescent assays. Front Immunol. 2023;14:1273476. doi: 10.3389/fimmu.2023.1273476</li>
 <li>Bonifacio E, Mathieu C, Nepom GT,&nbsp;et al.&nbsp;Rebranding asymptomatic type 1 diabetes: the case for autoimmune beta cell disorder as a pathological and diagnostic entity. Diabetologia. 2017;60(1):35−38. doi: 10.1007/s00125-016-4144-8</li>
 <li>Cherubini V, Grimsmann JM, Åkesson K, et al.&nbsp;Temporal trends in diabetic ketoacidosis at diagnosis of paediatric type 1 diabetes between 2006 and 2016: results from 13 countries in three continents. Diabetologia. 2020;63(8):1530−1541. doi: 10.1007/s00125-020-05152-1</li>
 <li>Sims EK, Besser REJ, Dayan C, et al.&nbsp;NIDDK Type 1 Diabetes TrialNet Study Group. Screening for Type 1 Diabetes in the General Population: A Status Report and Perspective. Diabetes. 2022;71(4):610−623. doi: 10.2337/dbi20-0054</li>
 <li>Quinn LM, Rashid R, Narendran P, et al.&nbsp;Screening children for presymptomatic type 1 diabetes. British Journal of General Practice&nbsp;2023;73(726):36−39. doi: 10.3399/bjgp23X731709</li>
 <li>McQueen RB,&nbsp;Rasmussen CG,&nbsp;Waugh K,&nbsp;et al. Cost and Cost-effectiveness of Large-scale Screening for Type 1 Diabetes in Colorado.&nbsp;Diabetes Care. 2020; 43(7):1496–1503.&nbsp;doi:10.2337/dc19-2003</li>
 <li>Catassi C, Vincentini O, Pricci F, et al.&nbsp;Pediatric screening for type 1 diabetes and celiac disease: the future is today in Italy. Minerva Pediatr (Torino). 2024;76(4):461−463. doi: 10.23736/S2724-5276.24.07573-6</li>
 <li>Hummel S, Carl J, Friedl N, et al. Fr1da Study Group. Children diagnosed with presymptomatic type 1 diabetes through public health screening have milder diabetes at clinical manifestation. Diabetologia. 2023;66(9):1633−1642. doi: 10.1007/s00125-023-05953-0</li>
 <li>Moore DJ, Leibel NI, Polonsky W, et al.&nbsp;Recommendations for Screening and Monitoring the Stages of Type 1 Diabetes in the Immune Therapy Era. Int J Gen Med. 2024;17:3003−3014. doi: 10.2147/IJGM.S438009</li>
 <li>American Diabetes Association Professional Practice Committee. 2. Diagnosis and Classification of Diabetes: Standards of Care in Diabetes-2024. Diabetes Care. 2024 Jan 1;47(Suppl 1):S20-S42. doi: 10.2337/dc24-S002</li>
 <li>STOP T1D. Module 4. Available at: https://www.stopt1dprogram.org/hcp-directory/module-4. Accessed: December&nbsp;2025</li>
 <li>Finding diabetes early can prevent serious illness and complications (no date) The Environmental Determinants of Diabetes in the Young (TEDDY). Available at: https://teddy.epi.usf.edu/. Accessed: December&nbsp;2025</li>
 <li>Phillip M, Achenbach P, Addala A, et al. Consensus guidance for monitoring individuals with islet autoantibody-positive pre-stage 3 type 1 diabetes. Diabetes Care. 2024;47(8):1276−1298. doi: 10.2337/dci24-0042</li>
 <li>Hilliard ME, Oser SM, Close KL, et al. From Individuals to International Policy: Achievements and Ongoing Needs in Diabetes Advocacy. Curr Diab Rep. 2015;15(9):59. doi:10.1007/s11892-015-0636-z. doi:10.1016/j.ssmmh.2024.100368</li>
</ol>

The ongoing paradigm shift in autoimmune type 1 diabetes (autoimmune T1D) care with early screening and risk monitoring can now help identify people at risk in the pre-symptomatic stages.1 The HCPs can be instrumental in enabling this shift by supporting knowledge dissemination and clinical application by early screening of autoimmune T1D.1,2 This approach ensures that benefits are realized by patients and caregivers at the early stage of autoimmune T1D.1,2

Early screening for autoimmune T1D: A paradigm shift in disease management

The progression of autoimmune type 1 diabetes (T1D) is gradual, often detectable months or even years before symptoms arise.1–3 Through proactive screening, we can identify the condition well in advance.3 Meet our ambassadors living with autoimmune T1D and discover the risk factors to look out for when considering who to screen.

Real-life stories from people living with autoimmune T1D 

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Real-life stories from people living with autoimmune T1D

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DISCOVER THE STORY INSIDE THE PANCREAS

Early identification of autoimmune type 1 diabetes can reduce its psychological impact.

Early screening for autoimmune T1D: A paradigm shift in disease management

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