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T1D AUTOANTIBODY SCREENING

 

PROACTIVE SCREENING FOR  T1D-RELATED ISLET AUTOANTIBODIES CAN IDENTIFY IF AN IMMUNE ATTACK IS HAPPENING1

Further zoomed out clusters of animated beta cells with worried expressions

THE AMERICAN DIABETES ASSOCIATION (ADA) RECOMMENDS PROACTIVELY SCREENING AT-RISK PATIENTS FOR THE FOLLOWING 4 ISLET AUTOANTIBODIES (AAbs)2*

GADA
(glutamic acid decarboxylase 65 AAb)

IA-2A
(insulinoma-associated antigen 2 AAb)

IAA
(insulin AAb)

ZnT8A
(zinc transporter-8 AAb)

*Islet cell AAb (ICA) is also available for testing.3

BETA-CELL DYSFUNCTION CAN BE DETECTED 4-6 YEARS BEFORE SYMPTOM ONSET 5,6
 

There are many benefits of proactive T1D screening

MAY REDUCE DKA RISK AT DIAGNOSIS

Although up to 70% of patients present with diabetic ketoacidosis (DKA) at diagnosis4,7, DKA exacerbates beta-cell loss, adding to the damage already caused by autoimmunity.8-10

DKA at diagnosis in associated with8,10-12:

 

A hospital

Hospitalization

A silhouette of a head with a brain inside of it

Neurocognitive
impairment

A blood glucose monitor

Poor glycemic
control over time

AVOID T2D MISDIAGNOSIS

It can be difficult to distinguish between the symptoms of T1D and T2D; this may lead to misdiagnosis, particularly in adults.2,3,17

Proactive autoantibody screening determines whether abnormal glucose levels are related to:

Crosshairs

Autoimmune attack
of beta cells

TYPE 1

A blood glucose monitor

Insulin resistance

TYPE 2

*In a retrospective online survey of 2,526 people with autoimmune T1D and caregivers of people with autoimmune T1D in the US, a diagnosis of autoimmune T1D was missed in 38.6% (n=330/856) of those aged ≥18 years. Of those people, 76.8% (n=253/330) were initially diagnosed with T2D.18

MORE TIME TO PREPARE AND BUILD A SUPPORT NETWORK

A negative test can give individuals and families peace of mind, while a positive result may give time to prepare.1 

An hourglass with all the sand at the bottom

MORE TIME:

  • Allows time to prepare and build a support network 

  • Offers time to seek T1D education and support

The Cost of Not Knowing research, from Beyond Type 1, was commissioned by Sanofi and conducted by Wakefield Research ( www.wakefieldresearch.com ). The research was conducted via two survey instruments—one among 1000 US adults with type 1 diabetes and a second among 1000 US caregivers to children under the age of 18 with type 1 diabetes, between March 15, 2024 and March 29, 2024, using an email invitation and an online survey.19

PATIENTS ELIGIBLE FOR SCREENING 

A family

Family history—first-degree relative:

UP TO 15x GREATER LIFETIME RISK OF DEVELOPING T1D

in individuals with a first-degree relative with T1D compared to the general population20

Crosshairs

Family history—autoimmune conditions:

There is a high correlation between T1D and other autoimmune conditions

2-3x HIGHER LIKELIHOOD OF DEVELOPING T1D

in those with celiac or autoimmune thyroid conditions vs those without21*

*From a retrospective, observational, matched-cohort study using real-world data from the Optum Clinformatics claims database including individuals with celiac disease, hyperthyroidism (including Graves’ disease), and hypothyroidism (including Hashimoto’s thyroiditis).21

A blood glucose monitor

People suspected of having T2 Prediabetes or T2D:

The clinical phenotype of T1D can overlap with T2 prediabetes and T2D,

MAKING IT CRUCIAL TO DIFFERENTIATE BETWEEN THE CONDITIONS22

Rising obesity in children and adolescents is emerging as a critical factor blurring the clinical distinction between T1D and T2D23-25

People with no known risk factors:

Approximately 10%

In the US, the incidence of T1D is projected to grow

~10% BY 203326*

90%

AROUND 90% OF NEW DIAGNOSES

occur in people with no family history of T1D27*

*Projected growth from 2024, assuming rising T1D incidence and improved survival with use of devices; by 2033, the US T1D population is projected to grow ~10% to ~2.29M, with increases largely driven by new cases and aging of the population.26
†From a population-based observational study of 57,371 young people with T1D recruited from across Germany, Austria, Switzerland, and Luxembourg, using data from the Diabetes Prospective Follow-up Registry between 1995 and 2018.27

 

EARLY DETECTION MATTERS


Learn more about the importance of screening and how early detection of T1D can improve outcomes.

References

  1. Scheiner G, Weiner S, Kruger DF, et al. Screening for type 1 diabetes: role of the diabetes care and education specialist. ADCES Pract. 2022;10(5):20-25.

  2. American Diabetes Association Professional Practice Committee. 2. Diagnosis and classification of diabetes: standards of care in diabetes—2025. Diabetes Care. 2025;48(suppl 1):S27-S49.

  3. Understanding A1C diagnosis. American Diabetes Association. Accessed March 6, 2026. https://www.diabetes.org/a1c

  4. 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.

  5. Koskinen MK, Helminen O, Matomaki J, et al. Reduced β-cell function in early preclinical type 1 diabetes. Eur J Endocrinol. 2016;174(3):251-259.

  6. Galderisi A, Carr ALJ, Martino M, et al. Quantifying beta cell function in the preclinical stages of type 1 diabetes. Diabetologia. 2023;66(12):2189-2199.

  7. Wolfsdorf JI, Glaser N, Agus M, et al. ISPAD Clinical Practice Consensus Guidelines 2018: diabetic ketoacidosis and the hyperglycemic hyperosmolar state. Pediatr Diabetes. 2018;19(suppl 27):155-177.

  8. Mortensen HB, Swift PGF, Holl RW, et al; Hvidoere Study Group on Childhood Diabetes. Multinational study in children and adolescents with newly diagnosed type 1 diabetes: association of age, ketoacidosis, HLA status, and autoantibodies on residual beta-cell function and glycemic control 12 months after diagnosis. Pediatr Diabetes. 2010;11(4):218-226.

  9. 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.

  10. Fernandez Castaner M, Montana E, Camps I, et al. Ketoacidosis at diagnosis is predictive of lower residual beta-cell function and poor metabolic control in type 1 diabetes. Diabetes Metab. 1996;22(5):349-355.

  11. Beliard K, Ebekozien O, Demeterco-Berggren C, et al. Increased DKA at presentation among newly diagnosed type 1 diabetes patients with or without COVID-19: data from a multi-site surveillance registry. J Diabetes. 2021;13(3):270-272.

  12. Ghetti S, Kuppermann N, Rewers A, et al; Pediatric Emergency Care Applied Research Network (PECARN) DKA FLUID Study Group. Cognitive function following diabetic ketoacidosis in young children with type 1 diabetes. Endocrinol Diab Metab. 2023;6:e412.

  13. Cato A, Hershey T. Cognition and type 1 diabetes in children and adolescents. Diabet Spectr. 2016;29(4):197-202.

  14. Elding Larsson H, Vehik K, Bell R, et al; TEDDY Study Group; SEARCH Study Group; Swediabkids Study Group; DPV Study Group; Finnish Diabetes Registry Study Group. Reduced prevalence of diabetic ketoacidosis at diagnosis of type 1 diabetes in young children participating in longitudinal follow-up. Diabetes Care. 2011;34(11):2347-2352.

  15. Besser REJ, Ng SM, Gregory JW, et al. General population screening for childhood type 1 diabetes: is it time for a UK strategy? Arch Dis Child. 2022;107(9):790-795.

  16. Ziegler AG, Kick K, Bonifacio E, et al; Fr1da Study Group. Yield of a public health screening of children for islet autoantibodies in Bavaria, Germany. JAMA. 2020;323(4):339-351.

  17. Holt RIG, DeVries JH, Hess-Fischl A, et al. The management of type 1 diabetes in adults. A consensus report by the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD). Diabetologia. 2021;64(12):2609-2652.

  18. Munoz C, Floreen A, Garey C, et al. Misdiagnosis and diabetic ketoacidosis at diagnosis of type 1 diabetes: patient and caregiver perspectives. Clin Diabetes. 2019;37(3):276-281.

  19. The price of uncertainty: unveiling the impact of unexpected type 1 diabetes diagnoses. Beyond Type 1. June 5, 2024. Accessed March 7, 2026. https://beyondtype1.org/unexpected-type-1-diabetes-diagnoses/

  20. Couper JJ, Haller MJ, Greenbaum CJ, et al. ISPAD Clinical Practice Consensus Guidelines 2018: stages of type 1 diabetes in children and adolescents. Pediatr Diabetes. 2018;19(suppl 27):20-27.

  21. Edelman SV, Agardh D, Cui N, et al. Risk of new-onset type 1 diabetes in individuals with celiac disease and thyroid disease—an observational study. Diabetes Obes Metab. 2025;27(8):4229-4238.

  22. Reynolds J. Key differences between type 1 and type 2 diabetes: a comprehensive guide. MyGlu.org. November 21, 2024. Accessed March 7, 2026. https://www.myglu.org/diabetes-overview-basics/differences-between-type-1-and-type-2-diabetes/

  23. Pulgaron E, Delamater A. Obesity and type 2 diabetes in children: epidemiology and treatment. Curr Diab Rep. 2014;14(8):508.

  24. DiMeglio L, Evans-Molina C, Oram RA. Type 1 diabetes. Lancet. 2018;391(10138):2449-2462.

  25. Washington R. Obesity may lead to confusion: type 1 versus type 2 diabetes. J Pediatr. 2013;162(4):736-740.

  26. Smith RA, Eisenberg S, Turner-Pfifer A, et al. We are on the verge of breakthrough cures for type 1 diabetes, but who are the 2 million Americans who have it? J Health Econ Outcomes Res. 2024;11(2):145-153.

  27. Karges B, Prinz N, Placzek K, et al. A comparison of familial and sporadic type 1 diabetes among young patients. Diabetes Care. 2021;44(5):1116-1124.

MAT-US-2504446-v2.0-03/2026