Early screening for type 1 diabetes

Diabetes is a widespread public health condition. According to estimates by the Hungarian Diabetes Association, approximately 800 000 people in Hungary are living with diabetes, around 10% of whom have type 1 diabetes (commonly abbreviated as T1D). This form of diabetes most often begins in childhood or adolescence, but it can develop at any age. The incidence of the disease is increasing year by year, and unfortunately more than one third of newly diagnosed cases are identified only when the patient is already in a severe, life-threatening condition (such as ketoacidosis or coma), requiring prolonged hospitalization and often intensive care treatment. Studies have shown that with an appropriate screening program, the disease can be identified at an early stage and these severe conditions can be prevented.

The exact cause of type 1 diabetes is not yet fully understood. However, it is known that in individuals with a certain genetic predisposition, the interaction with as yet unidentified environmental factors triggers an autoimmune process that destroys the insulin-producing beta cells of the pancreas.

With modern laboratory techniques, by testing for so-called T1D autoantibodies, it is now possible to determine with near 100% accuracy - while the individual is still symptom-free - who will develop the disease. This enables the prevention of life-threatening complications such as ketoacidosis and diabetic coma.

At what age do we recommend screening?

According to international professional guidelines, the first screening is ideally performed between the ages of 2 and 4. If the result is negative, repeat testing is recommended at 6-8 years of age, and - if this result is also negative - a further screening is advised between the ages of 10 and 15. Screening is also recommended at a later age if no previous testing has been performed.

If a positive result is obtained at any stage, the test must be repeated to confirm the finding. In cases that are confirmed and detected at an early stage, periodic blood glucose monitoring is carried out to ensure that appropriate treatment can be initiated in a timely manner and that severe, life-threatening conditions do not develop.

Benefits of screening for type 1 diabetes

• Prevention of life-threatening ketoacidosis and diabetic coma.
• Avoidance of prolonged hospitalisation.
• Prevention of misdiagnosis and timely initiation of insulin therapy.
• Improved quality of life and reduced psychological burden through preparation and patient education.
• Opportunity to apply potentially effective preventive treatments.

The insulin autoantibody panel includes the following laboratory tests:

• Tyrosine phosphatase (IA-2) autoantibodies
• Zinc transporter 8 autoantibodies (ZnT8A)
• GAD / GADA (glutamic acid decarboxylase autoantibodies)
• Insulin autoantibodies (IAA)