<h2>Understanding autoimmune T1D: Global prevalence and health burden</h2>
Globally, the prevalence of autoimmune T1D continues to rise.4

In 2025, an estimated 9.5 million people are living with autoimmune T1D, which is 13% more from 8.4 million in 2021. This number is expected to increase to 14.7 million by 2040, highlighting the growing global burden.4

<h2>Why is autoimmune T1D incidence rising globally?&nbsp;</h2>
The global burden of autoimmune T1D is rising due to the combined impact of increasing incidence, population growth, ageing, and falling mortality.4
<ul>
 <li>While T1D genetic susceptibility is polygenic, human leukocyte antigen Class II-associated polymorphisms account for approximately 50% of the inherited risk, yet most individuals with autoimmune T1D have no family history of the condition.1</li>
 <li>The increasing incidence of autoimmune T1D cases in genetically stable populations support a growing role of environmental factors in triggering β-cell-directed autoimmunity or accelerating the progression of autoimmune T1D; however, despite extensive investigation into viral infections, intestinal microbiota changes, and nutritional factors, the triggering agent and/or events remain unknown.1
 
 &nbsp;</li>
</ul>

<h2>Autoimmune T1D: Insights into pathophysiology and clinical features</h2>
Autoimmune T1D is a complex, chronic autoimmune condition driven by both genetic differences and environmental triggers.3 Progression of the condition involves both humoral and cell-mediated autoimmunity and is associated with loss of functional β‑cell mass.1 Clinically, autoimmune T1D typically presents with classic symptoms of polyuria, polydipsia, and polyphagia, often accompanied by ketosis and, particularly in pediatric cases, DKA:1

At initial diagnosis, 25%–50% of children manifest with DKA, compared to 6%–21% of adults. Autoimmune T1D can manifest at any age.1 In adults, approximately 38% of T1D cases are initially misdiagnosed as type 2 diabetes and treated with non-insulin antidiabetic therapies, highlighting the importance of accurate diagnosis.5

<h2>Autoimmune T1D staging and progression</h2>
The progression of T1D occurs silently through two defined stages before symptomatic onset:6

For children with presymptomatic T1D, 44% in stage 1 and 70% in stage 2 will progress to symptomatic T1D (stage 3) within 10 years.11 Early identification of presymptomatic T1D enables monitoring and reduces DKA risk at stage 3 diagnosis.2

<h2>Clinical benefits of early detection of autoimmune T1D through screening12-14</h2>
Presymptomatic autoimmune T1D screening enables timely monitoring and intervention before clinically significant β-cell loss, reducing the risk of DKA.2 When combined with education and metabolic monitoring, early identification of presymptomatic autoimmune T1D in children has been associated with improved clinical presentation at stage 3 onset, with lower prevalence of DKA and reduced rates of hospitalization and intensive care unit admissions.12 Primary care providers, such as pediatricians, family practitioners, and internal medicine physicians, play a central role in screening the general population for autoimmune T1D, as most individuals at risk for developing autoimmune T1D are unlikely to be under the care of an endocrinologist. It is therefore essential that primary care teams are engaged in screening efforts, with a focus on increasing awareness of early-stage T1D and available autoantibody screening options.2&nbsp;

<h2>Early detection of autoimmune T1D through screening: A proactive approach to reducing medical emergencies</h2>
Early detection of autoimmune T1D through screening significantly reduces medical emergency incidence at diagnosis. The ASK study demonstrated DKA rates could be lowered to approximately 5% in screened children compared to 60% in Colorado. Early detection affords families time for education and counselling before symptom onset, enhancing clinical presentation.2
Early detection of autoimmune T1D through screening involves a blood test for T1D autoantibodies against glutamic acid decarboxylase (GAD), insulin (IAA), islet antigen-2 (IA-2), and zinc transporter 8 (ZnT8). These autoantibodies serve as markers of the evolving autoimmune process.1,2
 
 &nbsp;

<h3>Existing population-wide screening programs for early detection of T1D are2</h3>

<h2>Conclusion</h2>
T1D progresses silently through stages 1 and 2 before becoming symptomatic at stage 3. Screening for T1D-associated autoantibodies significantly lowers the risk of DKA at diagnosis. Findings from the ASK study demonstrated that DKA rates dropped to about 5% in screened children, compared to 60% in unscreened populations in Colorado. Screening typically includes testing for specific autoantibodies against GAD, IAA, IA-2, and ZnT8. Early detection combined with metabolic monitoring can improve clinical outcomes and reduce risk of DKA at stage 3 onset. General population screening should be the ultimate goal to identify the majority of those that can/may develop T1D.
 
 &nbsp;

References
<ol>
 <li>Aamodt KI, Powers AC. The pathophysiology, presentation and classification of Type 1 diabetes. Diabetes Obes Metab. 2025;27 Suppl 6(Suppl 6):15–27. doi: 10.1111/dom.16628. Epub 2025 Jul 30. PMID: 40734585.</li>
 <li>Leichter SB, Felton JL, Geno Rasmussen C, Rizzuto P, Bellini N, Ebekozien O, et al. Establishing screening programs for presymptomatic type 1 diabetes: Practical guidance for diabetes care providers. J Clin Endocrinol Metab. 2025;110(8):2371–2382. doi: 10.1210/clinem/dgaf194. PMID: 40171881.</li>
 <li>Moore DJ, Leibel NI, Polonsky W, Rodriguez H. 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. PMID: 39011423.</li>
 <li>Ogle GD, Wang F, Haynes A, Gregory GA, King TW, Deng K, et al. Global type 1 diabetes prevalence, incidence, and mortality estimates 2025: Results from the International diabetes Federation Atlas, 11th Edition, and the T1D Index Version 3.0. Diabetes Res Clin Pract. 2025;225:112277. doi: 10.1016/j.diabres.2025.112277.</li>
 <li>Evans-Molina C, Oram RA. Type 1 diabetes presenting in adults: Trends, diagnostic challenges and unique features. Diabetes Obes Metab. 2025;27 Suppl 6(Suppl 6):57–68. doi: 10.1111/dom.16402. Epub 2025 Apr 15. PMID: 40230204.</li>
 <li>Mauvais FX, van Endert PM. Type 1 diabetes: A guide to autoimmune mechanisms for clinicians. Diabetes Obes Metab. 2025;27 Suppl 6(Suppl 6):40–56. doi: 10.1111/dom.16460. Epub 2025 May 15. PMID: 40375390.</li>
 <li>Haller MJ, Bell KJ, Besser REJ, Casteels K, Couper JJ, Craig ME, et al. ISPAD Clinical Practice Consensus Guidelines 2024: Screening, staging, and strategies to preserve beta-cell function in children and adolescents with type 1 diabetes. Horm Res Paediatr. 2024;97(6):529–545. doi: 10.1159/000543035. Epub 2024 Dec 11. PMID: 39662065.</li>
 <li>Stages of type 1 diabetes &amp; why they’re important | JDRF Australia. Available at: <a href="https://breakthrought1d.org.au/what-is-t1d/stages/" target="_blank">https://breakthrought1d.org.au/what-is-t1d/stages/</a>. Last accessed on June 23, 2026.</li>
 <li>Phillip M, Achenbach P, Addala A, Albanese-O'Neill A, Battelino T, Bell KJ, 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. PMID: 38912694.</li>
 <li>Anteby R, Lucander A, Bachul PJ, Pyda J, Grybowski D, Basto L, et al. Evaluating the prognostic value of islet autoantibody monitoring in islet transplant recipients with long-standing type 1 diabetes mellitus. J Clin Med. 2021;10(12):2708. doi: 10.3390/jcm10122708. PMID: 34205321.</li>
 <li>Bell KJ, Lain SJ. The changing epidemiology of type 1 diabetes: A global perspective. Diabetes Obes Metab. 2025 Aug;27 Suppl 6(Suppl 6):3–14. doi: 10.1111/dom.16501. Epub 2025. PMID: 40536127.</li>
 <li>Hummel S, Carl J, Friedl N, Winkler C, Kick K, Stock J, 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. Epub 2023 Jun 17. PMID: 37329450.</li>
 <li>Ziegler AG, Kick K, Bonifacio E, Haupt F, Hippich M, Dunstheimer D, et al; Yield of a public health screening of children for islet autoantibodies in Bavaria, Germany. JAMA. 2020;323(4):339–351. doi: 10.1001/jama.2019.21565. PMID: 31990315.</li>
 <li>Bonifacio E, et al. Effect of population-wide screening for presymptomatic early-stage type 1 diabetes on paediatric clinical care. Lancet Diabetes Endocrinol. 2024;12(6):376–378. doi: 10.1016/S2213-8587(24)00101-3.</li>
</ol>

Type 1 diabetes (T1D) is an autoimmune condition marked by reduction in insulin-producing β-cells, leading to an absolute or near-absolute insulin deficiency. The increasing incidence of autoimmune T1D in populations with relatively stable genetic backgrounds suggests that environmental factors are playing an increasingly important role in triggering β-cell-specific autoimmunity or accelerating the progression of autoimmune T1D.1 Screening for autoimmune T1D-associated autoantibodies represents a reliable method for identifying individuals in the presymptomatic stage, before significant β-cell loss and need for exogenous insulin therapy. Early identification of individuals with an increased chance of having autoimmune T1D enables timely monitoring and interventions, which can reduce the chance of experiencing a medical emergency like diabetic ketoacidosis (DKA).2

Rising incidence of autoimmune T1D: Need for screening

TZEILD

TYPE-1-DIABETES

DIABETES

<h2>What Are Type 1 Diabetes Autoantibodies?</h2>
Immune attack on pancreatic islet beta cells leads to progressive insulin deficiency and impaired glucose regulation. Islet-specific autoantibodies (such as GADA,&nbsp; IA-2A, IAA, and ZnT8A) typically emerge in early childhood often between 6 and &nbsp;24 months of age, with insulin autoantibodies peaking at 1-2 years and GAD65 autoantibodies appearing after the first year. The presence of autoantibodies indicates the initiation of beta cell autoimmunity (Stage 1), marking the start of immune-mediated reduction that eventually leads to irregular glucose levels and symptomatic autoimmune T1D. Environmental factors and genetic predisposition particularly HLA-DR3-DQ2 and HLA-DR4-DQ8 haplotypes play a critical role in initiating and accelerating condition progression.1,3
Autoimmune T1D progresses through four stages defined by genetic risk, autoantibody presence, and changes in glucose levels and beta cell function:4,9

Fig. Stages of type 1 diabetes4

<h3>Key autoantibodies in T1D and their pancreatic targets</h3>
Autoantibodies serve as critical biomarkers for diagnosis, staging, and prediction of condition progression. Their sequential appearance and epitope specificity provide insights into beta cell reduction and the pathophysiological timeline of autoimmune T1D.
<h4 style="text-align:center;">Table 1: Autoantibodies in type 1 diabetes4,5,9</h4>

<h4 style="text-align:center;">Table 2: Antibody Test Diabetes Type 1 and Common Detection Assays5,9,10</h4>

Abbreviations: ADAP, antibody detection by agglutination-PCR; ADA, American Diabetes Association; ECL, electrochemiluminescence; ELISA, enzyme-linked immunosorbent assay; LADA, latent autoimmune diabetes in adults; LIPS, luciferase immunoprecipitation system; PCR, polymerase chain reaction; RBA, radiobinding assay

<h2>Autoantibody-specific risk assessment2</h2>
While traditional risk stratification were focused primarily on autoantibody number and dysglycemia status, emerging evidence demonstrates that specific autoantibody types may have distinct prognostic implications for condition progression and clinical outcomes. Among these, IA-2A has emerged as one of the most clinically significant predictive markers, with recent data challenging conventional low-risk classifications for single autoantibody-positive individuals.

Fig. Autoantibody-specific risk assessment2

<h2>Screening strategies and early detection</h2>
Effective autoimmune T1D screening requires careful identification of high-risk groups and appropriate testing strategies. The ADA recommends prioritization of targeted screening in research settings over routine population-wide early detection of autoimmune type 1 diabetes through screening.7,8
<h4 style="text-align:center;">Table 3: Screening recommendations by population</h4>

Screening for islet autoantibodies in T1D enables the early detection of individuals who are at increased chance of developing autoimmune T1D. This early identification facilitates timely clinical staging and tracking, allowing healthcare providers and families to anticipate condition progression and consider preventive or therapeutic interventions such as humanized immunoglobulin G1 (IgG1) kappa CD3-directed monoclonal antibody to potentially delay or mitigate the onset of clinical T1D.8,9

<h2>The reliability of early detection of autoimmune type 1 diabetes through screening in clinical practice</h2>
The reliability of autoantibody screening has improved through international standardization efforts. Current testing approaches achieve &gt;95% specificity and &gt;85% sensitivity when using multiple autoantibody panels.6&nbsp;
<h3>Standardization and Diagnostic performance:&nbsp;</h3>
Standardization efforts, such as those led by the Islet Autoantibody Standardization Program (IASP), have improved the consistency of autoantibody assays across laboratories. These initiatives enabled inter-laboratory comparability. Sequential testing strategies beginning with GADA and IA-2A, followed by expanded panels if positive optimize both detection rates and cost-effectiveness.6&nbsp;
<h3>Multi-autoantibody panels, superior detection:&nbsp;</h3>
Multi-autoantibody screening demonstrates superior diagnostic accuracy compared to single-marker approaches. Approximately 10% of GADA-negative patients present with other anti-islet autoantibodies, underscoring why comprehensive panels are essential to prevent missed diagnoses in clinical practice.5
<h3>Progression risk:&nbsp;</h3>
The number and combination of autoantibodies directly influence condition progression risk and clinical management strategies. Single autoantibody positivity represents heterogeneous outcomes. Isolated GADA positivity allows stable glucose metabolism for extended periods. IA-2A or ZnT8A positivity indicates higher progression risk requiring enhanced monitoring.6
Multiple autoantibody positivity (≥2 autoantibodies) indicates high risk for T1D progression, with five-year and ten-year risks of approximately 44% and 70%, respectively, and lifetime risk approaching 100%.5 Longitudinal studies demonstrate that approximately 85% of genetically at-risk children with multiple autoantibodies progressed to clinical autoimmune T1D within 15 years.6
<h3>Population-based screening programs:&nbsp;</h3>
Real-world screening programs such as <a href="https://pmc.ncbi.nlm.nih.gov/articles/PMC3357246/" target="_blank">TrialNet</a>, <a href="https://pmc.ncbi.nlm.nih.gov/articles/PMC6990943/" target="_blank">Fr1da</a> (&gt;90,000 children), and <a href="https://pmc.ncbi.nlm.nih.gov/articles/PMC7775339/" target="_blank">ASK</a> (&gt;24,000 individuals) have expanded early detection of autoimmune T1D through screening both high-risk relatives and general population children, broadening reach beyond traditional research cohorts.6

<h2>Conclusions</h2>
Autoantibodies are biomarkers that indicate the stage and progression risk of autoimmune T1D. Their sequence of appearance and specific combinations reveal critical insights into the disease trajectory. While a single autoantibody may signal risk, the presence of multiple autoantibodies clearly indicates that the condition is progressive.
This predictive strength shapes clinical strategy and comprehensive multi-autoantibody panels deliver greater diagnostic accuracy than single-marker approaches, reducing missed diagnoses.
In essence, the sequential emergence and interplay of autoantibodies form the blueprint of autoimmune T1D. Recognizing this pattern early enables clinicians to stage disease precisely, anticipate progression confidently, and deploy preventive interventions proactively. By integrating standardized multi-autoantibody screening into practice, we move from reactive care to predictive precision reshaping the future of autoimmune T1D management.
*Human leukocyte antigen (HLA-DR3-DQ2, DR4-DQ8); DR3, DR4, DQ2, and DQ8 are the serotypes, or specific allelic variations (forms of the genes), present at these loci.
 
 &nbsp;

References
<ol>
 <li>Katsarou A, Gudbjörnsdottir S, Rawshani A, et al. Type 1 diabetes mellitus. Nat Rev Dis Primers. 2017;3:17016. doi:10.1038/nrdp.2017.16.</li>
 <li>Sims EK, Cuthbertson D, Ferrat LA, et al. IA-2A positivity increases risk of progression within and across established stages of type 1 diabetes. Diabetologia. 2025;68(5):993-1004. doi:10.1007/s00125-025-06382-x.</li>
 <li>Herold KC, Delong T, Perdigoto AL, Biru N, Brusko TM, Walker LSK. The immunology of type 1 diabetes. Nat Rev Immunol. 2024;24(6):435-451. doi:10.1038/s41577-023-00985-4.</li>
 <li>Sims EK, Besser REJ, Dayan C, et al. 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>Kawasaki E. Anti-Islet Autoantibodies in Type 1 Diabetes. Int J Mol Sci. 2023;24(12):10012. doi:10.3390/ijms241210012.</li>
 <li>So M, Speake C, Steck AK, et al. Advances in Type 1 Diabetes Prediction Using Islet Autoantibodies: Beyond a Simple Count. Endocr Rev. 2021;42(5):584-604. doi:10.1210/endrev/bnab013.</li>
 <li>Simmons KM, Sims EK. Screening and Prevention of Type 1 Diabetes: Where Are We? J Clin Endocrinol Metab. 2023;108(12):3067-3079. doi:10.1210/clinem/dgad328.</li>
 <li>Moore DJ, Leibel NI, Polonsky W, Rodriguez H. 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>Phillip M, Achenbach P, Addala A, et al. Consensus guidance for monitoring individuals with islet autoantibody-positive pre-stage 3 type 1 diabetes. Diabetologia. 2024;67(9):1731-1759. doi:10.1007/s00125-024-06205-5.</li>
 <li>Jia X, Yu L. Understanding Islet Autoantibodies in Prediction of Type 1 Diabetes. J Endocr Soc. 2024;8(1):bvad160. doi:10.1210/jendso/bvad160.
 
 &nbsp;</li>
</ol>

Autoimmune type 1 diabetes (T1D) is a lifelong autoimmune condition marked by progressive beta cell reduction. Autoantibodies targeting pancreatic islet antigens emerge months to years before clinical onset.1 The presence of autoantibodies signifies immune system dysregulation and facilitates the identification of individuals in the early stages of autoimmune T1D.2 This transformation enables predictive screening and timely intervention for individuals at risk.3

Type 1 Diabetes Autoantibodies: Early Detection and Risk Prediction

<h2>Why new type 1 diabetes guideline matter: Overcoming screening barriers</h2>
T1D management is undergoing a major shift.5 The condition often presents with life-threatening complications such as diabetic ketoacidosis (DKA) and has a profound impact on morbidity and longevity.4 To address this, the focus is moving toward early detection and presymptomatic intervention, enabling a more predictive approach to autoimmune T1D.5
Evidence shows that screening programs with long-term follow-up are associated with lower rates of DKA at diagnosis, improved short-term clinical outcomes, and reduced family/caregiver psychological burden.1 Early screening also allows families time to prepare, supports smoother transitions at diagnosis, and opens opportunities for clinical trial enrollment and access to therapies aimed at delaying progression if children are detected with multiple IAb.2,6,7
However, updated guidance and protocols are needed to fully integrate screening into routine practice.8 This article focuses on recent guideline updates in screening and monitoring, with the aim of addressing and overcoming key barriers to screening adoption.

<h2>2024-2026 T1D guideline updates: Key changes for HCPs</h2>
The recent updates from ISPAD, ADA, and International Consensus Report provide a comprehensive set of clinical recommendations for children, adolescents, and adults living with diabetes worldwide.1-3
<h2>ISPAD 2024 guidelines: New T1D screening and monitoring recommendations</h2>
<h3>Staging of autoimmune T1D</h3>
ISPAD introduces sub-stages for stage 2 and 3 and a stage 4 for long-standing autoimmune T1D.1

<h3>Who should be screened?</h3>
ISPAD supports general population screening to identify children and young adults with, or at increased likelihood of developing autoimmune T1D, using IAb or combined genetic and IAb approaches.1 ISPAD also recommends screening in children with a genetic component that increases their likelihood of autoimmune T1D.1
<h3>Screening modality</h3>
Guideline currently recommends two strategies for autoimmune T1D screening:1
<ol>
 <li>IAb screening in children with increased likelihood of autoimmune T1D (family history)</li>
 <li>IAb screening in the general population</li>
</ol>
&nbsp;
IAb screening is done to detect antibodies against insulin, glutamic acid decarboxylase (GAD), insulinoma-associated protein 2 (IA-2), and zinc transporter 8 (ZnT8).1

<h3>Guideline recommendations for monitoring</h3>
Age and number of IAb dictate the frequency and intensity of recommended monitoring for those with single or multiple IAb.1
<h4 style="text-align:center;">ISPAD recommendations on monitoring children with autoimmune T1D1</h4>

<h2>ADA 2026 guidelines: What's new in autoimmune T1D screening and staging</h2>
<h3>Staging of autoimmune T1D</h3>
The ADA guidelines incorporate glycated hemoglobin (HbA1c) criteria (5.7–6.4% [39–47 mmol/mol] or a ≥10% increase in HbA1c) as part of the diagnostic framework for irregular glucose levels in stage 2.2
<h3>Recommendations on screening2</h3>

When multiple IAb are confirmed, referral to a specialized center for evaluation and/or potential trial/therapy should be considered.2

<h2>Key updates on screening and monitoring from International Consensus Report 2024</h2>
<h3>Staging of autoimmune T1D</h3>
In addition to the core stages (stage 1-3), the International Consensus Report introduces a pre-stage 1 autoimmune T1D (this stage indicates individuals who are with higher chance of developing autoimmune T1D).3
<h3>Recommendations on screening of autoimmune T1D</h3>
<ul>
 <li>Highlights early T1D screening to reduce DKA and allow access to progression-delaying therapies3</li>
 <li>Notes that widespread screening identifies individuals who are at higher chance of or living with early-stage autoimmune T1D needing ongoing monitoring3</li>
</ul>
<h3>Confirmation of multiple IAb status</h3>
<h4 style="text-align:center;">‘The rule of twos’ and IAb persistence3</h4>

The ‘rule of twos’, endorsed by International Consensus Report, guides early autoimmune T1D identification by requiring persistent positivity for two distinct autoantibodies, confirmed in two tests with two separate samples, to reliably indicate early autoimmune activity.3
Predicting progression to stage 3 autoimmune T1D in individuals with diabetes-related autoantibodies is challenging. In children and adolescents, persistent positivity for multiple IAb confirms early-stage (stage 1 or 2) and indicates a higher chance of progression compared to single IAb status; therefore, confirmation of multiple IAb should follow the “rule of twos.”3
<h3>Risk stratification</h3>
The risk of progression to autoimmune T1D in children and adolescents can be stratified based on several factors.3

<h3>Autoimmune type 1 diabetes monitoring guideline recommendations as per International Consensus Report</h3>
<h4 style="text-align:center;">International Consensus Report recommendations on monitoring3</h4>

<h2>Conclusion</h2>
Early detection of autoimmune T1D opens a window for presymptomatic intervention and reduces life-threatening complications and hospitalizations.1,5 Recent updates from ISPAD, ADA, and the International Consensus Report overcome barriers to screening by providing clearer recommendations on staging, screening criteria, and monitoring, supporting general population screening, confirmation of autoimmune T1D using the “rule of twos,” and age- and stage-based monitoring to enable timely intervention and research participation.1-3

References
<ol>
 <li>Haller MJ, Bell KJ, Besser REJ, Casteels K, Couper JJ, Craig ME, et al. ISPAD clinical practice consensus guidelines 2024: Screening, staging, and strategies to preserve beta-cell function in children and adolescents with type 1 diabetes. Horm Res Paediatr. 2024;97(6):529–545. doi: 10.1159/000543035. PMID: 39662065.</li>
 <li>American Diabetes Association Professional Practice Committee for Diabetes. 2. Diagnosis and Classification of Diabetes: Standards of Care in Diabetes-2026. Diabetes Care. 2026;49(Suppl 1):S27–S49. doi: <a href="https://diabetesjournals.org/care/article/49/Supplement_1/S27/163926/2-Diagnosis-and-Classification-of-Diabetes" target="_blank">https://doi.org/10.2337/dc26-S002</a>.</li>
 <li>Phillip M, Achenbach P, Addala A, Albanese-O'Neill A, Battelino T, Bell KJ, et al. Consensus guidance for monitoring individuals with islet AAB-positive pre-stage 3 type 1 diabetes. Diabetes Care. 2024;47(8):1276–1298. doi: 10.2337/dci24-0042.</li>
 <li>Sims EK, Besser REJ, Dayan C, Geno Rasmussen C, Greenbaum C, Griffin KJ, et al. 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. PMID: 35316839.</li>
 <li>Cavalli E, Nicoletti GRP, Nicoletti F. A historical and epistemological review of type 1 diabetes mellitus. J Clin Med. 2025;14(14):4923. doi: 10.3390/jcm14144923. PMID: 40725617.</li>
 <li>Simmons KM, Sims EK. Screening and prevention of type 1 diabetes: Where are we? J Clin Endocrinol Metab. 2023;108(12):3067–3079. doi: 10.1210/clinem/dgad328. PMID: 37290044.</li>
 <li>Insel RA, Dunne JL, Atkinson MA, Chiang JL, Dabelea D, Gottlieb PA, 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. PMID: 26404926.</li>
 <li>Leichter SB, Felton JL, Geno Rasmussen C, Rizzuto P, Bellini N, Ebekozien O, et al. Establishing Screening Programs for Presymptomatic Type 1 Diabetes: Practical Guidance for Diabetes Care Providers. J Clin Endocrinol Metab. 2025;110(8):2371–2382. doi: 10.1210/clinem/dgaf194. PMID: 40171881.</li>
</ol>

Recent updates from International Society for Pediatric and Adolescent Diabetes (ISPAD) 2024, American Diabetes Association (ADA) 2026, and International Consensus Report 2024 introduce important refinements to autoimmune type 1 diabetes (T1D) management protocols.1-3 These evidence-based enhancements provide healthcare providers (HCPs) with clearer pathways for screening, staging, and monitoring—addressing key barriers to screening adoption.1-3

Latest guideline updates in autoimmune T1D screening and monitoring

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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MAT-US-2405606-v1.0-06/2024

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