Table 1.

Pros and cons of screening for type 1 diabetes

Pros	Cons
Possible prevention of DKA at onset of diabetes	Potential increased anxiety in parents/carers
Opportunity for time to adjust to diagnosis	High numbers of individuals genetically at risk, but who don’t develop T1D
Genetic testing for high-risk genes/genetic risk scores possible at birth for use in combination with autoantibodies	If using IAb alone: - Likely need testing more than once - Will miss those diagnosed before screening and those who seroconvert after screening
IAb detectable with fingerprick test, easy to administer, sensitive and specific	Treatment of early hyperglycaemia can be challenging
May be intervention studies to delay development or prevent T1D	Cost/effectveness still a matter of debate
New drug (teplizumab) available to delay the onset of T1D in high-risk individuals	No drug licensed to definitively prevent diabetes

Modified from Besser R.E.J. et al., Arch Dis Chil 2022