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Peer-reviewedCC BY 4.0Diabetologia

International consensus guidance for general population screening for islet autoantibodies to diagnose early-stage type 1 diabetes: a nominal group technique process

  • Anette-Gabriele Ziegler1,2,3
  • Marian J. Rewers4
  • Peter Achenbach1,2,3
  • Kirstine J. Bell5
  • Ezio Bonifacio6,7
  • Linda A. DiMeglio8
  • Sanjoy Dutta9
  • Helena Elding Larsson10,11
  • Brigitte I. Frohnert4
  • Kurt J. Griffin12,13
  • William A. Hagopian14
  • Laura M. Jacobsen15
14 more authors
  • Karin Lange16
  • Roberto Mallone17,18,19
  • Parth Narendran20,21
  • Tal Oron22,23
  • Stephen S. Rich24
  • Caitrin W. McDonough25
  • Darja Šmigoc Schweiger26,27
  • Zdenek Šumník28
  • Agnieszka Szypowska29
  • Riitta Veijola30,31
  • Jurgen Vercauteren32
  • John M. Wentworth33,34
  • Diane K. Wherrett35
  • Anastasia Albanese-O’Neill36
36 affiliations
  1. 1Institute of Diabetes Research, Helmholtz Munich, German Research Center for Environmental Health, Munich-Neuherberg, Germany
  2. 2School of Medicine and Health, Forschergruppe Diabetes, TUM University Hospital, Technical University of Munich, Munich, Germany
  3. 3German Center for Diabetes Research (DZD e.V.), Neuherberg, Germany
  4. 4Barbara Davis Center for Diabetes, University of Colorado Anschutz Medical Campus, Aurora, CO USA
  5. 5Charles Perkins Centre and Faculty of Medicine and Health, University of Sydney, Sydney, NSW Australia
  6. 6Center for Regenerative Therapies Dresden, Faculty of Medicine, Technical University of Dresden, Dresden, Germany
  7. 7Paul Langerhans Institute Dresden, Helmholtz Centre Munich at the University Clinic Carl Gustav Carus of TU Dresden and Faculty of Medicine, Dresden, Germany
  8. 8Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN USA
  9. 9Breakthrough T1D, New York, NY USA
  10. 10Department of Clinical Sciences Malmö, Lund University, Lund, Sweden
  11. 11Department of Pediatrics, Skåne University Hospital, Malmö, Sweden
  12. 12Benaroya Research Institute, Seattle, WA USA
  13. 13Department of Pediatrics, Sanford School of Medicine, University of South Dakota, Sioux Falls, SD USA
  14. 14Dept of Pediatrics, Indiana University, Indianapolis, IN USA
  15. 15Department of Pediatrics, Division of Endocrinology, University of Florida College of Medicine, Gainesville, FL USA
  16. 16Medical Psychology, Hannover Medical School, Hannover, Germany
  17. 17Institut Cochin, CNRS, Inserm, Université Paris Cité, Paris, France
  18. 18Department of Diabetology and Clinical Immunology, Assistance Publique Hôpitaux de Paris, Cochin Hospital, Paris, France
  19. 19Indiana Biosciences Research Institute, Indianapolis, IN USA
  20. 20Queen Elizabeth Hospital, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
  21. 21Department of Immunology and Immunotherapy, University of Birmingham, Birmingham, UK
  22. 22The Jesse and Sara Lea Shafer Institute of Endocrinology and Diabetes, Schneider Children’s Medical Center of Israel, Petach-Tikva, Israel
  23. 23Gray Faculty of Medical & Health Sciences, Tel Aviv University, Tel Aviv, Israel
  24. 24Department of Genome Sciences, University of Virginia, Charlottesville, VA USA
  25. 25Department of Pharmacotherapy and Translation Research, College of Pharmacy, University of Florida, Gainesville, FL USA
  26. 26Department of Endocrinology, Diabetes and Metabolic Diseases, University Children’s Hospital, University Medical Centre Ljubljana, Ljubljana, Slovenia
  27. 27Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
  28. 28Department of Pediatrics, 2nd Faculty of Medicine, Charles University in Prague and Motol University Hospital, Prague, Czechia
  29. 29Department of Pediatric Diabetology and Pediatrics, Medical University of Warsaw, Warsaw, Poland
  30. 30Department of Pediatrics, Research Unit of Clinical Medicine, Medical Research Center, University of Oulu, Oulu, Finland
  31. 31Department for Children and Adolescents, Medical Research Center, Oulu University Hospital, Oulu, Finland
  32. 32Department of Chronic Diseases and Metabolism, KU Leuven, Leuven, Belgium
  33. 33St Vincent’s Institute of Medical Research, Fitzroy, VIC Australia
  34. 34Department of Diabetes and Endocrinology, Royal Melbourne Hospital, Parkville, VIC Australia
  35. 35Department of Pediatrics, The Hospital for Sick Children, University of Toronto, Toronto, ON Canada
  36. 36Breakthrough T1D, Gainesville, FL USA
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Abstract

Type 1 diabetes is an autoimmune disease that targets and destroys insulin-producing beta cells in the pancreatic islets. The incidence of type 1 diabetes is rising globally. At the clinical diagnosis of type 1 diabetes, between 20% and 67% of children and adolescents present with diabetic ketoacidosis (DKA) requiring hospitalisation, and one-third of these require intensive care. Type 1 diabetes can be detected in early stages, prior to the insulin-requiring clinical diagnosis, through screening for islet autoantibodies (IAbs). Identifying individuals with early-stage type 1 diabetes, combined with monitoring of and education on disease progression, prevents DKA and results in a milder clinical onset. This allows for timely insulin initiation in outpatient settings and improved long-term glucose management. Early diagnosis also enables access to novel disease-modifying therapies that can delay the clinical onset of diabetes. In this international consensus, we provide guidance on the principles and practice of implementing general population screening for IAbs to diagnose early-stage type 1 diabetes. We also outline the minimum requirements for establishing effective population screening programmes to diagnose early-stage type 1 diabetes through IAb detection. This consensus statement has been endorsed by the following professional associations: Advanced Technologies & Treatments for Diabetes (ATTD); Association of Diabetes Care and Education Specialists (ADCES); Association Belge Du Diabète; Associazione Medici Diabetologi (AMD); Australian Diabetes Society (ADS); Belgian Diabetes Liga; Breakthrough T1D; Czech Diabetes Society (ČDS); EASD; Finnish Diabetes Association (FDS); Fondazione Italiana Diabete (FID); International Diabetes Federation (IDF)-Europe; International Society of Paediatric and Adolescent Diabetes (ISPAD); Paediatric Endocrinology Nursing Society (PENS); Polish Diabetes Society; Portuguese Diabetes Association (APDP); Sociedade Portuguesa de Diabetologia (SPD); Società Italiana di Diabetologia (SID); Société Francophone du Diabète (SFD) and Type 1 Diabetes Exchange (T1D Exchange).

Graphical Abstract:

Supplementary Information: The online version contains peer-reviewed but unedited supplementary material available at https://doi.org/10.1007/s00125-026-06841-z.

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Cite

BibTeXRIS
BibTeX
@article{ziegler2026international,
  title = {{International consensus guidance for general population screening for islet autoantibodies to diagnose early-stage type 1 diabetes: a nominal group technique process}},
  author = {Anette-Gabriele Ziegler and Marian J. Rewers and Peter Achenbach and Kirstine J. Bell and Ezio Bonifacio and Linda A. DiMeglio and Sanjoy Dutta and Helena Elding Larsson and Brigitte I. Frohnert and Kurt J. Griffin and William A. Hagopian and Laura M. Jacobsen and Karin Lange and Roberto Mallone and Parth Narendran and Tal Oron and Stephen S. Rich and Caitrin W. McDonough and Darja Šmigoc Schweiger and Zdenek Šumník and Agnieszka Szypowska and Riitta Veijola and Jurgen Vercauteren and John M. Wentworth and Diane K. Wherrett and Anastasia Albanese-O’Neill},
  journal = {Diabetologia},
  year = {2026},
  month = sep,
  doi = {10.1007/s00125-026-06841-z},
  url = {https://doi.org/10.1007/s00125-026-06841-z},
  note = {CC BY 4.0},
}
RIS
TY  - JOUR
TI  - International consensus guidance for general population screening for islet autoantibodies to diagnose early-stage type 1 diabetes: a nominal group technique process
AU  - Anette-Gabriele Ziegler
AU  - Marian J. Rewers
AU  - Peter Achenbach
AU  - Kirstine J. Bell
AU  - Ezio Bonifacio
AU  - Linda A. DiMeglio
AU  - Sanjoy Dutta
AU  - Helena Elding Larsson
AU  - Brigitte I. Frohnert
AU  - Kurt J. Griffin
AU  - William A. Hagopian
AU  - Laura M. Jacobsen
AU  - Karin Lange
AU  - Roberto Mallone
AU  - Parth Narendran
AU  - Tal Oron
AU  - Stephen S. Rich
AU  - Caitrin W. McDonough
AU  - Darja Šmigoc Schweiger
AU  - Zdenek Šumník
AU  - Agnieszka Szypowska
AU  - Riitta Veijola
AU  - Jurgen Vercauteren
AU  - John M. Wentworth
AU  - Diane K. Wherrett
AU  - Anastasia Albanese-O’Neill
PY  - 2026
DA  - 2026/09/10
JO  - Diabetologia
DO  - 10.1007/s00125-026-06841-z
UR  - https://doi.org/10.1007/s00125-026-06841-z
AB  - Type 1 diabetes is an autoimmune disease that targets and destroys insulin-producing beta cells in the pancreatic islets. The incidence of type 1 diabetes is rising globally. At the clinical diagnosis of type 1 diabetes, between 20% and 67% of children and adolescents present with diabetic ketoacidosis (DKA) requiring hospitalisation, and one-third of these require intensive care. Type 1 diabetes can be detected in early stages, prior to the insulin-requiring clinical diagnosis, through screening for islet autoantibodies (IAbs). Identifying individuals with early-stage type 1 diabetes, combined with monitoring of and education on disease progression, prevents DKA and results in a milder clinical onset. This allows for timely insulin initiation in outpatient settings and improved long-term glucose management. Early diagnosis also enables access to novel disease-modifying therapies that can delay the clinical onset of diabetes. In this international consensus, we provide guidance on the principles and practice of implementing general population screening for IAbs to diagnose early-stage type 1 diabetes. We also outline the minimum requirements for establishing effective population screening programmes to diagnose early-stage type 1 diabetes through IAb detection. This consensus statement has been endorsed by the following professional associations: Advanced Technologies & Treatments for Diabetes (ATTD); Association of Diabetes Care and Education Specialists (ADCES); Association Belge Du Diabète; Associazione Medici Diabetologi (AMD); Australian Diabetes Society (ADS); Belgian Diabetes Liga; Breakthrough T1D; Czech Diabetes Society (ČDS); EASD; Finnish Diabetes Association (FDS); Fondazione Italiana Diabete (FID); International Diabetes Federation (IDF)-Europe; International Society of Paediatric and Adolescent Diabetes (ISPAD); Paediatric Endocrinology Nursing Society (PENS); Polish Diabetes Society; Portuguese Diabetes Association (APDP); Sociedade Portuguesa de Diabetologia (SPD); Società Italiana di Diabetologia (SID); Société Francophone du Diabète (SFD) and Type 1 Diabetes Exchange (T1D Exchange).  Graphical Abstract:  Supplementary Information: The online version contains peer-reviewed but unedited supplementary material available at https://doi.org/10.1007/s00125-026-06841-z.
SN  - 0012-186X
SN  - 1432-0428
ER  -