Table 2:

World Health Organization Requirements for Screening

WHO Criteria	Type 1 Diabetes
The condition should be an important health problem	Life-threatening diabetic ketoacidosis Life-threatening hypoglycemia Micro- and macrovascular complications
There should be a treatment for the condition	Insulin
Facilities for diagnosis and treatment should be available	Pediatric and adult endocrine clinics are prominent in the US
There should be a latent stage of the disease	Preclinical phase marked by multiple islet autoantibodies in the serum
There should be a test or examination for the condition	Serum islet autoantibodies
The test should be acceptable to the population	All four major islet autoantibodies are commercially available
The natural history of the disease should be adequately understood	T1D is a chronic progressive autoimmune disease (see Figure 1)
There should be an agreed policy on whom to treat	American Diabetes Association clinical care guidelines
The total cost of finding a case should be economically balanced in relation to medical expenditure as a whole	Screening modalities are improving, such as using dried blood spots to measure IAs Economic burden of T1D is high
Case finding should be a continuous process, not just a “once and for all” project	Risk determination can be incorporated into pediatric well child visits

IAs = islet autoantibodies; T1D = type 1 diabetes; WHO = World Health Organization.