A New Framework for Detecting Type 1 Diabetes Before Symptoms Begin

Type 1 diabetes doesn't appear overnight. In the years before someone develops symptoms, the immune system begins attacking the insulin-producing cells in the pancreas. During this preclinical stage, a person can test positive for islet autoantibodies—molecular markers that indicate autoimmunity is underway—but they have no symptoms and normal blood sugar levels.

Identifying people in this preclinical stage has become possible thanks to autoantibody screening. However, without a unified approach, screening and monitoring practices have varied widely across regions and healthcare systems, creating gaps in care and inconsistent follow-up.

A new consensus document from Spanish diabetes experts (the SED-SEEN-SEEP collaboration) has developed an Integrated Care Pathway (ICP)—a structured, step-by-step model for identifying and monitoring preclinical Type 1 diabetes. The pathway organizes the screening and follow-up process into four interconnected parts.

The first step focuses on identifying who should be screened. The second involves testing for and confirming islet autoantibodies. The third includes long-term clinical follow-up and staging to track how the disease progresses. A fourth, supporting component uses information systems and performance measures to ensure the pathway works consistently and can be tracked over time.

Before this pathway, screening and follow-up for preclinical Type 1 diabetes lacked consistency. Different healthcare settings used different approaches, timelines, and criteria—making it difficult for families to understand their options or for doctors to coordinate care across institutions.

A standardized, scalable framework helps ensure that anyone at risk receives the same quality of screening and monitoring, regardless of where they live or receive care. It also creates a common language for clinicians, researchers, and families, making it easier to track outcomes and improve the model over time.

For people with a family history of Type 1 diabetes or those identified as at risk, this pathway offers a clearer roadmap. Rather than facing fragmented or inconsistent care, they can expect organized screening, confirmation of results, and planned follow-up visits tailored to their stage of disease.

Having a structured approach also supports research. By standardizing how preclinical Type 1 diabetes is detected and monitored, scientists can better understand disease progression and test new interventions aimed at delaying or preventing clinical onset.

Source: Endocrinologia, diabetes y nutricion. Evidence type: PubMed indexed literature. Type1Cure is an information and intelligence hub, not a medical advice service. This article summarizes published research and does not provide diagnosis, treatment, or personal medical guidance. Always talk to your own care team before changing anything about your Type 1 diabetes management.