Screening and prevention of type 1 diabetes: Where are we?

A diagnosis of type 1 diabetes and the subsequent requirement for exogenous insulin treatment is associated with considerable acute and chronic morbidity and a significant impact on patient quality of life. Importantly, a large body of work suggests that early identification of pre-symptomatic type 1 diabetes can accurately predict clinical disease, and when paired with education and monitoring, can yield improved health outcomes. Furthermore, a growing cadre of effective disease-modifying therapies provides the potential to alter the natural history of pre-symptomatic type 1 diabetes. In this mini review, we highlight prior work that has led to the current landscape of type 1 diabetes screening and prevention, as well as challenges and next steps moving into the future of these rapidly evolving areas of patient care.