Increasing HbA1c in children and youth with a first-degree relative with type 1 diabetes predicts progression to diabetes: a single-centre 10-year screening experience

In recent years, screening for Type 1 Diabetes (T1D) has been increasingly enhanced thanks to its demonstrated benefits in preventing diabetic ketoacidosis (DKA) at T1D onset and the availability of emerging disease-modifying therapy that can delay disease progression. Most screening programs have been performed as part of research trials and specific programs involving individuals with a family history of T1D, high-risk HLA genotype or the general population [1]. Evidence from these programs supports the increasing inclusion of screening in the national health system, as recently done in Italy thanks to the approval of a law introducing a nationwide screening for T1D and coeliac disease in the general pediatric population, with the pilot phase currently ongoing. The 15-fold increased risk of developing T1D in individuals with a first-degree relative who has T1D suggests screening family members as part of clinical care in pediatric diabetes centers. This has also been suggested as an intermediate step towards general population screening. The aim of this study was to assess the prevalence and predictors of T1D stages among children and youth who, over the last ten years, attended the T1D screening program of the Regional Center of Pediatric Diabetes of Verona (Italy).