By Amber Jackson, RN, DCES
Why don’t we think about type 1 diabetes (T1D) risks, screening, and prevention planning like we do the other health monsters…heart disease, obesity, allergies, cancer and the effects of smoking.
New research suggests that even families already affected by T1D may not fully understand their risk—or know that screening is available.
A 2026 national survey of 1,000 adults and caregivers with a first-degree family history of T1D found that 26% did not believe they or their child were at increased risk, while 31% did not know that family history increases T1D risk at all. Even more concerning, 26% believed screening could only be performed after symptoms developed.
T1D Starts Before the Symptoms
Type 1 diabetes doesn’t suddenly begin the day someone develops excessive thirst, frequent urination, weight loss or diabetic ketoacidosis (DKA).
It is an autoimmune process in which the immune system progressively attacks the insulin-producing beta cells of the pancreas. Today, blood tests can look for several T1D-associated islet autoantibodies—including antibodies to insulin, GAD, IA-2 and ZnT8—before symptomatic diabetes develops. The 2026 American Diabetes Association Standards of Care recommend offering autoantibody screening to people with a family history of T1D or another known elevated genetic risk.
And family history isn’t the whole story.
Approximately 90% of people who develop T1D do not have a family history of the disease. That is one reason researchers are increasingly studying broader population screening rather than limiting our attention exclusively to relatives of people with T1D.
Why Screen Early for Type 1 Diabetes?
Because knowing can change what happens next.
Early identification allows people who test positive to receive education, additional testing and ongoing monitoring rather than simply waiting for symptoms to appear. Research suggests that monitoring people at high risk can dramatically reduce the likelihood that their eventual diagnosis occurs during DKA. In screening studies, DKA rates at diagnosis have fallen from approximately 25–62% without monitoring to about 4–6% with monitoring and follow-up.
Early detection may also open the door to clinical trials and, for eligible individuals with stage 2 T1D, therapies intended to delay progression to symptomatic stage 3 disease. Current ADA guidance recommends that people with multiple confirmed islet autoantibodies be referred to a specialized center for metabolic staging, education and consideration of prevention trials or approved treatments such as teplizumab.
Screening Is Only the Beginning
One particularly telling finding from the 2026 survey was that 17% of respondents said they wouldn’t know what to do if screening showed increased T1D risk.
That matters.
A positive antibody result shouldn’t leave someone with a laboratory report and a frightening Google search. It should lead to education, monitoring, support and a plan.
At Integrated Diabetes Services, we offer Beta Cell Bubble Wrap, a program designed for individuals who test positive for T1D autoantibodies.
The program provides support, education, and strategies aimed at protecting beta-cell function and slowing the progression of T1D where possible, while helping individuals and families understand what their results mean and what comes next.
Put T1D on the Radar
Perhaps the biggest shift needs to be how we think about T1D itself.
We shouldn’t only think about type 1 diabetes when someone becomes sick.
We shouldn’t assume it is exclusively a childhood disease—the survey found that 63% of respondents still believed T1D is primarily diagnosed during childhood, even though the disease can develop at any age.
And we shouldn’t assume that having no family history means having no risk.
Just as conversations about obesity, smoking, allergies and cardiovascular risk have become part of preventive health, T1D risk and early detection deserve a place in that conversation too.
We now have the ability to identify autoimmune T1D before the traditional symptomatic diagnosis. The challenge is making sure people—and their healthcare providers—know to think about it.
Know the risk. Know that screening exists. And if antibodies are found, don’t stop at the test—get a plan.
Resources
- Ebert M. Family history alone may not prompt type 1 diabetes screening, survey finds. Contemporary Pediatrics. July 30, 2026. Based on The Family Factor: A T1D Risk Awareness Survey, Beyond Type 1/Sanofi, conducted by Ipsos, April–May 2026.
- American Diabetes Association Professional Practice Committee. Diagnosis and Classification of Diabetes: Standards of Care in Diabetes—2026. Diabetes Care. 2026;49(Suppl 1).
- Herold KC, et al. Screening for Type 1 Diabetes in the General Population: A Status Report and Perspective. Diabetes. 2022;71(4):610–623.
