Experts Call for Wider Screening to Detect Type 1 Diabetes Before Symptoms

International diabetes experts are calling for wider access to a blood test that can detect the early stages of Type 1 diabetes before symptoms appear, potentially shifting diagnosis away from waiting for high blood sugar and noticeable warning signs toward identifying the disease during its earliest autoimmune stages.

The recommendation is part of new international guidance published on September 10, 2026, in Diabetologia, which supports using islet autoantibody testing in broader population screening programs where appropriate systems are available to confirm results and monitor people found to have early signs of the disease.

The test itself is not new. What is changing is the push to use it more broadly as a tool for early detection of Type 1 diabetes in people who may not yet know the disease has begun developing.

The blood test looks for autoantibodies produced when the immune system begins attacking the insulin-producing cells of the pancreas. These immune markers can appear while a person still has normal blood glucose levels and no symptoms such as excessive thirst, frequent urination or unexplained weight loss.

When two or more Type 1 diabetes-related autoantibodies are confirmed, doctors may be able to identify people who have already entered an early stage of the disease and begin monitoring them for changes in blood glucose before clinical diabetes develops.

Experts say that earlier identification could also reduce the risk of Type 1 diabetes being discovered only after a patient develops diabetic ketoacidosis, a serious complication caused by severe insulin deficiency.

Evidence reviewed in the guidance indicates that between 20% and 67% of children and adolescents with Type 1 diabetes may have diabetic ketoacidosis at the time of diagnosis, while structured screening and monitoring programs have been associated with lower rates of the complication.

The guidance recommends initial screening in childhood between the ages of 2 and 4, followed by repeat testing between 6 and 8, and again between 10 and 15 for children who previously tested negative. Screening may also be considered for people older than 15 who have never been tested, although evidence supporting population-wide screening in adults remains more limited.

A single positive result does not mean that a person has clinical diabetes or will soon require insulin. The guidance recommends confirming positive findings with a second blood sample and providing ongoing medical monitoring when autoimmune markers are verified.

The significance of the new recommendations therefore lies not in the creation of a new blood test, but in a proposed expansion of an existing test from more limited use toward broader early screening, allowing Type 1 diabetes to be identified while it is developing rather than only after symptoms appear.