Simple autoantibody testing can diagnose T1D members in subclinical stages of the disease1-4

Although guidelines do not currently recommend screening for T1D autoantibodies, there may be value in identifying the risk of members within your plan. A panel of islet autoantibodies is currently recommended in research settings or as an option for first-degree family members of a T1D patient.1-4

Many in the T1D community are aware that screening for autoantibodies is possible but are resistant2:
  • There are no treatment options regardless of diagnosis, so prognosis will not change

  • The fear that knowledge of pending progression will bring unnecessary stress
Approximately 15% of those with T1D have a first-degree relative (parent, sibling, or child) with the disease5

Recent studies have shown that identifying and monitoring at-risk patients decreases incidence of DKA:

DKA was reduced from
~46% to ~15% in a Colorado-
based study6

In Germany, close
monitoring further reduced
DKA from ~20% to ~3%3

Identifying patients
earlier through
autoantibody testing
enables enhanced
monitoring for
comorbidities2

Screening family members for autoantibodies is an effective way of reducing DKA.2,3

The cost-effectiveness of
screening

Screening in practice, the
Fr1da Study

Screening populations has been shown to reduce dangerous outcomes such as diabetic ketoacidosis (DKA)7-9

T1D Screening

DKA at diagnosis of T1D is both a short-term hazard and a harbinger of what’s to come10:

  • DKA at diagnosis is causally linked to increased morbidity and mortality associated with poor glycemic control
  • Effects of DKA are independent of other indicators of poor glycemic control such as demographic and socioeconomic factors

Early T1D diagnosis may improve short- and long-term outcomes3,11,12

T1D Screening

1. Bingley PJ, Bonifacio E, Ziegler AG, Schatz DA, Atkinson MA, Eisenbarth GS; Immunology of Diabetes Society. Proposed guidelines on screening for risk of type 1 diabetes. Diabetes Care. 2001;24(2):398. 2. Narendran P. Screening for type 1 diabetes: are we nearly there yet? Diabetologia. 2019;62(1):24-27. 3. Ziegler AG, Kick K, Bonifacio E, et al; for Fr1da Study Group. Yield of a public health screening of children for islet autoantibodies in Bavaria, Germany. JAMA. 2020;323(4):339-351. 4. American Diabetes Association. Classification and Diagnosis of Diabetes: Standards of Medical Care in Diabetes-2020. Diabetes Care. 2020;43(suppl 1):S14-S31. 5. Beck RW, Tamborlane WV, Bergenstal RM, Miller KM, DuBose SN, Hall CA; for T1D Exchange Clinic Network. The T1D exchange clinic registry. J Clin Endocrinol Metab. 2012;97(12):4383-4389. 6. Rewers M, Geno-Rasmussen C, Liu E, et al. General population screening for type 1 diabetes and celiac disease: autoimmunity screening for kids (ASK). Poster presented at EASD Annual Meeting; September 16-20, 2019; Barcelona, Spain. 7. Lind M, Svensson AM, Kosiborod M, et al. Glycemic control and excess mortality in type 1 diabetes. N Engl J Med. 2014;371(21):1972-1982. 8. Mencher SR, Frank G, Fishbein J. Diabetic ketoacidosis at onset of type 1 diabetes: rates and risk factors today to 15 years ago. Glob Pediatr Health. 2019;6:1-9. 9. Rewers A, Dong F, Slover RH, Klingensmith GJ, Rewers M. Incidence of diabetic ketoacidosis at diagnosis of type 1 diabetes in Colorado youth, 1998-2012. JAMA. 2015;313(15):1570-1572. 10. Duca LM, Wang B, Rewers M, Rewers A. Diabetic ketoacidosis at diagnosis of type 1 diabetes predicts poor long-term glycemic control. Diabetes Care. 2017;40(9):1249-1255. 11. JDRF. Diabetic ketoacidosis (DKA): symptoms and prevention. https://www.jdrf.org/t1d-resources/about/symptoms/ketoacidosis/. Accessed August 17, 2020. 12. Barker JM, Goehrig SH, Barriga K, et al. Clinical characteristics of children diagnosed with type 1 diabetes through intensive screening and follow-up. Diabetes Care. 2004;27(6):1399-1404.