Early screening for type 1 diabetes found effective in children

Researchers from the University of Birmingham have reported efficacy from childhood screening for type 1 diabetes, publishing their findings in The Lancet Diabetes & Endocrinology.¹

More than 1 in 4 children are only diagnosed with type 1 diabetes following diabetic ketoacidosis, which can be fatal and requires immediate hospitalization. These results highlight the potential to identify type 1 diabetes before symptoms appear, significantly reducing the risk of emergency diagnoses.¹

“We are working towards a future where type 1 diabetes can be detected in a timely manner, and families appropriately supported and treated with medicines to delay the need for insulin,” said Parth Narendran, PhD, professor of diabetes medicine at the University of Birmingham.¹

Screening methodology and sample collection

The study was conducted to develop a screening program for type 1 diabetes in the United Kingdom.² Participants included pediatric patients aged 3 to 13 years residing in the United Kingdom without type 1 diabetes.

These patients provided a capillary dried blood spot (DBS) sample that was assessed using the 3 Screen ELISA (RSR, Cardiff, UK) for islet autoantibodies. The samples could be self-collected at home or obtained with help from a health care professional in clinical or community settings.²

If a sample received a positive screening, the patient was invited to undergo confirmation islet autoantibody testing on a venous blood sample. Glucose tolerance test staging was offered to patients with at least 2 islet autoantibodies to confirm presymptomatic type 1 diabetes presence.²

Participant characteristics and screening outcomes

Parents and guardians of children with positive tests for islet autoantibodies were offered an education session. The final analysis included 24,875 children aged a median 8 years. Of these patients, 51.61% were male, 80.96% White, 2.09% Black, 6.53% Asian, 7.08% mixed, and 2.55% other race or ethnicity.²

A history of type 1 diabetes was reported in 32.47% of the study population, and 15.46% had an affected first-degree relative. Home testing was provided to 61.93% of patients, while 21.58% were tested in schools, 5.31% at general practice surgeries, 10.11% in other community clinics, and 1.07% in hospitals.²

Of the 17,931 DBS cards returned, 17,283 were analyzed. There were 87 adverse events reported, all of which were resolved without long-term effects. Qualitative interviews indicated parents found these adverse events to be acceptable. A positive screening was reported in:²

• 3.73% of patients with an affected first-degree relative
• 2.24% of patients with any family history of type 1 diabetes
• 0.25% of patients with no family history of type 1 diabetes

Testing feasibility

The overall DBS return rate was 69.48%, exceeding other programs such as the NHS England bowel cancer screening program with a 67% kit return rate. According to investigators, this highlights the feasibility and acceptability of confirmatory testing.²

Experts have also noted a 15% chance of developing type 1 diabetes withing 10 years among children with 1 autoantibody, while the presence of 2 or more antibodies indicates an almost certain need for insulin therapy.¹ These presences were identified in 75 and 160 children, respectively, alongside an additional 7 needing to start insulin immediately.

“Thanks to scientific breakthroughs, we now have the tools to identify children in the very earliest stages of type 1 diabetes - giving families precious time to prepare, avoid emergency hospital admissions, and access treatments that can delay the need for insulin for years,” said Elizabeth Robertson, PhD, Director of Research and Clinical at Diabetes UK.¹

References

1. National childhood type 1 diabetes screening is effective and could prevent thousands of emergency diagnoses, UK study shows. University of Birmingham. January 20, 2026. Accessed February 2, 2026. https://www.eurekalert.org/news-releases/1113300
2. Quinn LM, Elliott J, Papanikolaou T, et al. Feasibility of general population screening for type 1 diabetes in the UK: the ELSA study. The Lancet Diabetes & Endocrinology. 2026. doi:10.1016/S2213-8587(25)00363-8