Simplification of type 1 Diabetes screening and follow-up at pediatric age to facilitate large-scale implementation

Abstract

Type 1 Diabetes (T1D) is a chronic autoimmune disease common in children, with increasing worldwide prevalence. The cost to public health is high, just as the impact on the quality of life of patients and families. Several efforts seek to introduce screening to delay or try to stop the autoimmune process, highlighting the recent approval of teplizumab by the FDA (Food and Drug Administration) in individuals with T1D in an asymptomatic stage. In addition, screening can reduce morbidity and mortality associated with an unexpected diagnosis of the disease, such as diabetic ketoacidosis, a potentially fatal event that can be the first manifestation of the disease. Most cases of T1D (almost 90%) have no family history, so efforts are being made to implement population-based screening. This article aims to simplify the heterogeneity of screening methods and follow-up, with the goal of facilitating conclusions and identifying the current obstacles to the effectiveness of large-scale screening.