Early detection of type 1 diabetes (T1D)

Detecting type 1 diabetes early gives you time and options 

You know the phrase “knowledge is power”? That’s what you gain when you or a family member gets screened for type 1 diabetes (T1D). There are multiple significant benefits to detecting T1D early, months or years before the onset of clinical symptoms: 

  1. Opportunity for disease-modifying therapies delay the onset of T1D. 
  2. Opportunity for psychological adjustment and reducing stress at time of clinical onset
  3. Time for education on T1D management 
  4. Reduced risk of diabetic ketoacidosis (DKA) at time of clinical diagnosis 

Thanks to recent medical breakthroughs, when you detect T1D early you gain time to prepare for future needs—and may even be able to delay the need for insulin therapy.

How does T1D screening work?

T1D doesn’t show up overnight—it develops in stages over time. 

A simple blood test can identify proteins in the blood called islet autoantibodies. These proteins may signal that the body’s immune system is attacking cells in the pancreas that produce insulin. If a person has two or more autoantibodies on more than one test, it is very likely they’ll develop T1D. 

The chart below explains the different stages of T1D and the symptoms that families should be aware of during monitoring. 

Stage 1 type 1 diabetes
In stage 1, a person has no symptoms, and their blood glucose levels are normal, but blood tests show multiple autoantibodies.

Stage 2 type 1 diabetes
Someone progresses to stage 2 when blood glucose levels start to vary abnormally when they eat or drink carbohydrates. There are still no symptoms at this stage. Once symptoms begin to show up, clinical diagnosis is made.

New treatments like teplizumab are available for those with stage 2 T1D and can delay the onset of stage 3 T1D.

Stage 3 – 4 type 1 diabetes – clinical diagnosis of T1D
In stage 3 – 4, symptoms of type 1 diabetes (such as excessive thirst, toileting, losing weight, and fatigue) are present. At this stage, insulin-producing cells have been damaged enough to require insulin therapy.

What are your screening options?

Type 1 diabetes can now be identified early, before insulin is required, with a specialized blood test that looks for T1D autoantibodies. 

Learn about your options to screen for early stage T1D, including free research studies and through your doctor’s office. 

How to get screened for T1D
Your age, risk factors, and other criteria determine which screening options you’re eligible for. 

For people with a family history of T1D
People with a family history of T1D may be eligible for TrialNet. For people living in Quebec, another option is the FEDERATE-Can project. 

TrialNet is a free, research-based T1D early detection and clinical trial program for family members of people with T1D. This network of experts has sites in many countries, including in Canada, and T1D screening can be done through an at-home kit or in person. 

The program is available for individuals between the ages of 2 and 45 years with a first-degree relative (parent, child, sibling) with T1D, ages 2 to 20 with a second-degree relative (cousin, grandparent) with T1D, OR anyone ages 2 to 45 years who has tested positive for at least one T1D-related autoantibody outside of TrialNet. 

FEDERATE-Can is available for Québec residents aged 18-65 who are first-degree relatives of people with T1D. Screening is performed in Montréal. Details are available on the project’s website. 

For everyone
Talk to your doctor or healthcare provider. Ask your doctor to consult www.uncovert1d.ca for information about which tests to order. (Note: this website contains information specifically for healthcare providers that your doctor can consult.) 

After testing, be sure to follow up. If autoantibodies are present, repeat testing is required to confirm. 

CanScreen T1D
In Canada, a research consortium called the Canadian Population Screening for Risk of Type 1 Diabetes (CanScreen T1D) is working to understand how we can make risk screening for newborns and children a reality across Canada. 

Because most people who develop T1D don’t have a family connection, CanScreen T1D is asking the general population how they feel about being offered T1D risk screening and what it should look like. They are also studying what would be needed scientifically and practically to make this screening available to every child living in Canada. 

Jointly with community members and experts across the country, they are co-designing a pilot T1D risk screening program for the general population. The consortium is also creating decision-making tools and educational materials to help families understand their options for screening, coming up with follow-up strategies, facilitating participation in clinical trials, and much more. Breakthrough T1D Canada is proud to be funding this work in partnership with the Canadian Institutes of Health Research (CIHR). 

What do my results mean?

Autoantibodies detected
If autoantibodies are detected on your screening test, this means you could have early-stage type 1 diabetes. It is important that you repeat this test to check if the autoantibodies are confirmed and persistent (present at two separate testing times). 

You will require additional testing to determine staging. One persistent autoantibody means you may be at risk for developing type 1 diabetes. Two or more persistent autoantibodies means you have early-stage type 1 diabetes. 

No autoantibodies detected
If your screening test does not show any islet autoantibodies, this means you do not have early-stage type 1 diabetes. Most people who undergo screening for T1D will receive this result. However, you may still develop autoantibodies in the future, especially if T1D runs in your family. Someone at a high genetic risk should consider being re-screened every couple of years. 

Talk to your healthcare provider about participating in T1D screening again in the future, especially if you are under the age of 18. 

Donate | Donnez