Researchers in Germany have reported new data supporting population-wide screening for early-stage type 1 diabetes in children, demonstrating that islet autoantibody testing can identify presymptomatic disease years before clinical diagnosis.
Published in JAMA, the findings come from a large screening program conducted in Bavaria between 2015 and 2025. More than 220,000 children were screened through 716 primary care pediatric practices using tests for islet autoantibodies associated with type 1 diabetes.
Among the 220,476 children enrolled, 590 were diagnosed with presymptomatic (stage 1 or 2) type 1 diabetes during their initial screening. After adjustment, the population prevalence was estimated at 0.3%, including 0.23% with stage 1 disease and 0.06% with stage 2 disease. A second round of screening in a subset of children identified 29 additional cases.
Tracking progression to clinical disease
Children diagnosed with early-stage disease were offered diabetes education, metabolic assessment, and ongoing monitoring through specialized diabetes centers. During a median follow-up period of 5.7 years, 217 children identified through screening progressed to clinical (stage 3) type 1 diabetes. An additional 43 children who had not been diagnosed with early-stage disease during screening also developed stage 3 diabetes.
Overall, screening detected 81% of children who went on to develop clinical diabetes during follow-up. Researchers calculated a five-year progression rate from early-stage to clinical disease of 36.2%, corresponding to an annualized progression rate of 9.6%.
Notably, progression rates were similar among children with and without a first-degree family history of type 1 diabetes. The finding suggests that disease progression after the onset of islet autoimmunity may be comparable regardless of family history.
The researchers concluded that general population screening can successfully identify children with presymptomatic type 1 diabetes and may help support the development and evaluation of therapies designed to delay clinical disease onset. The results also suggest that screening strategies could be expanded beyond genetically selected or family-history–based populations as efforts to identify at-risk children continue to evolve.
Note: This news summary was generated by AI based on a published press release, followed by a review from human editors.
