Why Type 1 Diabetes Antibody Screening Matters

Lindsay Cohen, RDN

Credit: Mama-Betes

Type 1 diabetes is an autoimmune disease where the body’s immune system attacks and destroys the cells that produce insulin. Unfortunately, by the time typical symptoms like increased thirst and frequent urination appear, quite a bit of damage has already been done.

This delay in symptoms can lead to serious complications, including diabetic ketoacidosis (DKA). Screening for Type 1 diabetes antibodies offers a way to identify individuals at risk before these symptoms develop, potentially changing the course of the disease.

Type 1 Diabetes Autoantibodies

Antibody screening for Type 1 diabetes involves testing for specific autoantibodies in the blood. These autoantibodies are markers of the autoimmune process that comes before the actual onset of Type 1 diabetes. Detecting these autoantibodies allows for the identification of those who are at increased risk of developing the disease, often years before any symptoms occur.

The presence of autoantibodies indicates an increased risk of developing Type 1 diabetes; however, some people with autoantibodies never develop the disease. The more autoantibodies a person has, the higher their risk of developing Type 1 diabetes.

The most common autoantibodies screened for include the following:

• Glutamic acid decarboxylase (GAD): GAD is an enzyme found in the beta cells. They are the most common type of autoantibody found in people with Type 1 diabetes.
• Insulinoma-associated-2 (IA-2): IA-2 autoantibodies are less common than GAD autoantibodies, but they are still a strong indicator of Type 1 diabetes.
• Insulin autoantibodies: Insulin autoantibodies are directed against insulin itself. They can be present in people with Type 1 diabetes who have not yet been diagnosed.
• Zinc transporter 8 (ZnT8): ZnT8 autoantibodies are a newly identified type of autoantibody that can be present in people with Type 1 diabetes.

Why Early Screening Is Important

Early detection through antibody screening offers several benefits, including the following:

• Proactive monitoring: Screening helps identify individuals at high risk, allowing for closer monitoring and proactive management.
• Prevention and intervention: Research is ongoing to explore interventions that may delay or prevent the onset of Type 1 diabetes in those identified with autoantibodies. Clinical trials are investigating therapies aimed at preserving beta-cell function.
• Avoiding DKA: Early detection can prevent DKA by allowing for timely diagnosis and initiation of insulin therapy before severe complications arise.
• Psychological preparation: Knowing the risk allows families to prepare for the potential development of Type 1 diabetes, both emotionally and practically.

Who Should Be Screened?

While universal screening for Type 1 diabetes antibodies is not yet standard practice in the United States, certain groups are considered to be at higher risk and may benefit from screening.

Anyone with a first-degree relative (parent, sibling or child) with Type 1 diabetes has an increased risk. Those with other autoimmune diseases, such as celiac disease or autoimmune thyroid disease, may also have a higher risk and would benefit from screening.

The Future of Type 1 Diabetes Screening

Advances in technology are making antibody screening more accessible and accurate. The ultimate goal is to move toward a future where Type 1 diabetes can be prevented or significantly delayed. This requires continued research, increased awareness and broader implementation of antibody screening.

Antibody screening for Type 1 diabetes is a powerful tool for identifying those who may be at risk and paving the way for early intervention. By screening, we can take proactive steps to protect individuals and improve outcomes for those affected by this challenging disease.

Increased awareness, access to testing and ongoing research are key to tapping into the full potential of antibody screening. You can learn more about screening for Type 1 diabetes, how to get screened and what the results mean through Breakthrough T1D.