Czechia Launches First Large-Scale Type 1 Diabetes Screening Program for Children

Czechia has launched the Betty project, a nationwide screening program designed to identify children in the early stages of Type 1 diabetes before they develop symptoms. The program is part of EDENT1FI, a European initiative working to implement screening, monitoring, and prevention strategies for childhood Type 1 diabetes across the continent.

Unlike screening programs that focus only on high-risk families, the Betty project offers testing to all children aged 2 to 17.9 years, regardless of whether they have a family history of Type 1 diabetes. This population-wide approach aims to catch the disease in its earliest detectable phase.

The Betty project uses a two-step screening process designed to be accessible and accurate. In the first step, children receive a simple capillary blood test (a finger-prick sample) that screens for four islet-specific autoantibodies: anti-GAD, anti-IA2, anti-ZnT8, and IAA. These autoantibodies are immune markers that appear when the body's immune system begins attacking the insulin-producing cells in the pancreas.

If the initial screening sample shows signs of autoantibodies, the same sample is sent to the EDENT1FI reference laboratory for more detailed testing. If results suggest autoantibodies are present, children are then asked to provide a venous blood sample (a traditional blood draw) to confirm the findings.

This layered approach helps reduce false positives while ensuring that children with genuine autoantibody markers are identified and move forward for clinical evaluation.

Children who test positive for multiple confirmed autoantibodies are identified as having early-stage Type 1 diabetes. These children are offered personalized follow-up care based on their individual estimated risk of progressing to clinical diabetes—the stage where symptoms like thirst, frequent urination, and fatigue typically appear.

Children found to have only a single confirmed autoantibody receive follow-up monitoring, though typically less intensive than those with multiple markers. The presence of autoantibodies does not mean a child will definitely develop Type 1 diabetes, but it does indicate an increased risk that warrants tracking over time.

Between April 2024 and February 2026, the Betty project collected capillary blood samples from 19,044 children—representing approximately 1% of the Czech pediatric population. Samples were gathered from 270 screening sites, primarily at primary care facilities, with 4.1% of samples collected through home sampling.

This represents one of the first large-scale population-based screening efforts for Type 1 diabetes in Europe, offering researchers and clinicians valuable data about the prevalence of autoantibodies in children without known risk factors and the feasibility of implementing screening programs across diverse settings.

Traditional screening often focuses on children with a family history of Type 1 diabetes. However, many children who develop Type 1 diabetes have no known family history. By screening all children regardless of family background, programs like Betty can identify at-risk children who might otherwise go undetected until symptoms appear.

Early detection allows for closer monitoring and the possibility of future interventions—such as clinical trials or preventive treatments—while children are still in the early autoimmune stage. This proactive approach represents a shift toward precision medicine in Type 1 diabetes care.

Source: Diabetes, obesity & metabolism. 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.