Changing the Story of Type 1 Diabetes Starts with Early Detection

Screening can give people and families time to prepare, connect with care and improve the outlook for their long-term health.

For generations, type 1 diabetes (T1D) has been diagnosed only after the body sounds an urgent alarm. A person becomes intensely thirsty, experiences nausea and vomiting, extreme fatigue or other serious symptoms. A family that began the day unaware of T1D may end it in an emergency department, learning how to manage a lifelong condition.

But a medical crisis should never be the starting point for T1D care.

Our understanding of T1D has advanced dramatically. We now recognize it not simply as a condition that appears suddenly, but as a progressive autoimmune disease that may seem invisible but can be identified before symptoms begin. As the science has evolved, our approach to diagnosis must evolve with it, making the invisible visible.

For decades, blood tests have been able to detect the autoantibodies that signal T1D disease before symptoms appear. A growing body of compelling evidence has shown short- and long-term benefits of identifying the disease early.

The question is no longer whether we can identify T1D earlier. It is whether we seize this important opportunity and make early identification of disease a routine part of care.

To understand why this shift matters, we must consider the remarkable possibilities screening creates.

T1D screening can transform an emergency into a plan

T1D often begins years before symptoms appear, as the immune system gradually attacks the pancreas’s insulin-producing beta cells.¹ Fortunately, a positive result from a blood test for T1D autoantibodies can identify the disease during its earlier stages, creating a critical window where patients and families can see the disease coming instead of being blindsided by it.²

This is because the most common complication when T1D is diagnosed in the late-stage is diabetic ketoacidosis (DKA), a serious, potentially life-threatening condition in which acids called ketones build up in the blood and may require hospitalization.² The risk is especially pronounced in children, with approximately 56% of newly diagnosed pediatric T1D cases presenting with DKA at diagnosis.³

The most immediate benefit from screening is a lower risk of experiencing DKA at diagnosis. Research shows screening programs have substantially reduced these incidents among children whose disease was detected and followed before symptoms emerged.⁴

For families at risk, there’s a clear line between knowledge and empowered action. They can learn the signs of progression, meet the clinicians who will guide them and understand available monitoring and treatment options.⁵

The potential impact of knowing earlier

The benefits from screening may extend well beyond diagnosis. By the time T1D is diagnosed after symptoms develop, a person may already have lost much of their irreplaceable insulin-producing capacity.^6,7

That matters profoundly because even small amounts of the body’s own insulin production can help smooth fluctuations of glucose to make the disease easier to manage. Across multiple studies, people diagnosed with T1D who have clinically meaningful C-peptide levels, an important marker of insulin production by beta cells, experience lower rates of both short- and long-term complications.⁸

Even small amounts of residual insulin production have been associated with meaningful clinical benefits, including lower rates of DKA and severe hypoglycemia, reduced insulin requirements, and a decreased risk of microvascular complications such as diabetic retinopathy and nephropathy.^9-11

Importantly, screening may help reduce the risk of adverse neurocognitive outcomes by enabling earlier identification of T1D before progression to DKA. In young children with T1D, moderate-to-severe DKA at diagnosis has been associated with altered brain growth and lower performance on measures of intelligence, attention, and memory.^12-13

Turning earlier detection into transformative care

Screening does not eliminate the risks from T1D. But it must be recognized as a powerful opportunity to diagnose T1D before a potentially preventable crisis, begin care with more of the body’s vital function intact and reduce the risk of serious complications from the disease at diagnosis.

Healthcare professionals and providers can make T1D autoantibody screening a pivotal conversation, particularly for people with a family history or other risk factors, while continuing to build pathways for confirmatory testing, education, monitoring and referral.

The opportunity to identify T1D earlier is here. Now is the time to work together to make screening for early T1D disease, and the supporting care it requires, a routine part of our health system.

Discover how earlier screening can help reshape the T1D experience: Explore the importance of early detection and screening.

References:

1. Insel RA, Dunne JL, Atkinson MA, et al. (2015) Staging Presymptomatic Type 1 Diabetes: A Scientific Statement of JDRF, the Endocrine Society, and the American Diabetes Association. Diabetes Care, 38(10):1964–1974.
2. Screening for Type 1 Diabetes. (2026, April 17). Centers for Disease Control and Prevention. https://www.cdc.gov/diabetes/diabetes-testing/screening-type-1-diabetes.html.
3. McQueen RB, Chen NC, Gutierrez EJ, et al. (2026) Identifying diabetic ketoacidosis encounters at diagnosis among children with type 1 diabetes in claims data. Journal of the Endocrine Society, 10(8):bvag146. PubMed Central. doi:10.1210/jendso/bvag146.
4. Larsson H, Vehik K, Bell R, et al. (2011) Reduced Prevalence of Diabetic Ketoacidosis at Diagnosis of Type 1 Diabetes in Young Children Participating in Longitudinal Follow-Up. Diabetes Care, 34 (11): 2347–2352. PubMed Central. https://doi.org/10.2337/dc11-1026.
5. Heltzel P, Alexander C. (2026, July 15) Type 1 Diabetes Screening Can Give Families More Time. DiaTribe. https://diatribe.org/diabetes-management/type-1-diabetes-screening-can-give-families-more-time.
6. E Niechciał, Wais P, A Kędzia. (2026) Ketoacidosis at childhood type 1 diabetes onset negatively affects residual beta-cell functions during the first year after diagnosis. Nature, 16(1):6957. PubMed Central. doi:10.1038/s41598-026-38533-4.
7. Andersen M, Rasmussen M, S Pörksen, et al. (2013) Complex Multi-Block Analysis Identifies New Immunologic and Genetic Disease Progression Patterns Associated with the Residual β-Cell Function 1 Year after Diagnosis of Type 1 Diabetes. PLoS One, 8(6), e64632. PubMed Central. doi:10.1371/journal.pone.0064632.
8. Jeyam A, Colhoun H, McGurnaghan S, et al. (2021) Clinical Impact of Residual C-Peptide Secretion in Type 1 Diabetes on Glycemia and Microvascular Complications. Diabetes Care, 44(2), 390–398. PubMed Central. Doi:10.2337/dc20-0567.
9. Sørensen JS, Johannesen J, Pociot F, et al. (2013) Danish Society for Diabetes in Childhood and Adolescence. Residual β-cell function 3-6 years after onset of type 1 diabetes reduces risk of severe hypoglycemia in children and adolescents. Diabetes Care, 36(11):3454-3459. PubMed Central. Doi: 10.2337/dc13-0418.
10. Harsunen M, Haukka J, Harjutsalo V, et al. (2023) Residual insulin secretion in individuals with type 1 diabetes in Finland: longitudinal and cross-sectional analyses. Lancet Diabetes Endocrinol. 11(7):465-473. PubMed Central. Doi: 10.1016/S2213-8587(23)00123-7.
11. Mellor JH, Blackburn LAK, McGurnaghan SJ, et al. (2024) Long-term effect of C-peptide on clinical outcomes in the Scottish Type 1 Bioresource cohort. Abstract presented at: IDS 2024 Congress; November 7-8, 2024; Bruges, BE. Accessed March 7, 2026. https://idsbruges2024.com/wp-content/uploads/2024/10/IDS-BOA_PDF-2.pdf.
12. Ghetti S, Kuppermann N, Rewers A, et al. (2023). Cognitive function following diabetic ketoacidosis in young children with type 1 diabetes. Endocrinology, Diabetes & Metabolism, 6:e412. PubMed Central. doi:10.1002/edm2.412.
13. Aye T, Mazaika P, Mauras N, et al. (2019) Diabetes Research in Children Network (DirecNet) Study Group; Impact of Early Diabetic Ketoacidosis on the Developing Brain. Diabetes Care, 42(3), 443–449. PubMed Central. doi: 10.2337/dc18-1405.
    

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