Type 1 diabetes is an autoimmune disease in which the immune system progressively attacks the beta cells in the pancreas responsible for producing insulin. This process can begin months or years before the first symptoms appear.

Type 1 diabetes screening involves a blood test that detects autoantibodies associated with this autoimmune process, even when blood glucose levels are still normal.

The presence of certain autoantibodies, particularly when two or more are detected and their persistence is confirmed, may indicate that a person is in an early stage of type 1 diabetes, even if they have no symptoms.

Detecting type 1 diabetes before its clinical onset makes it possible to establish specialist monitoring, anticipate potential complications at diagnosis and identify people who could benefit from new treatment options.

What are the stages of type 1 diabetes?

Three main stages are currently recognised in the progression of type 1 diabetes:

Stage 1: autoimmunity without abnormal glucose levels

Two or more autoantibodies associated with type 1 diabetes are detected, but blood glucose levels remain normal. The person has no symptoms.

Stage 2: autoimmunity with abnormal glucose levels

In addition to the presence of two or more autoantibodies, abnormalities in blood glucose levels begin to develop, although the diagnostic criteria for clinical diabetes have not yet been met. The person remains asymptomatic.

Stage 3: clinical type 1 diabetes

The disease now meets the diagnostic criteria for diabetes. Symptoms such as excessive thirst, increased urination, weight loss or fatigue may appear, and insulin treatment generally needs to be started.

Identifying type 1 diabetes at stages 1 and 2 is essential to anticipate its clinical onset. At stage 2, selected patients may be eligible for immunomodulatory treatments that can delay progression to stage 3.

Screening is intended for people who do not yet have symptoms of type 1 diabetes but may be at increased risk of developing the disease.

Screening should be particularly considered for:

· First-degree relatives of people with type 1 diabetes: parents, siblings and children.

· People with a high genetic predisposition or risk factors that warrant specialist assessment.

· Other asymptomatic individuals for whom a specialist considers screening appropriate.

Having a family member with type 1 diabetes does not necessarily mean that a person will develop the disease. However, family history is an important factor when assessing individual risk.

Screening can also detect presymptomatic type 1 diabetes in people without a family history, although screening recommendations and programmes may vary depending on age and risk profile.

The type 1 diabetes screening test is straightforward: it involves a conventional blood sample that is analysed for up to four types of antibodies associated with the autoimmune destruction of insulin-producing beta cells. The markers typically tested include anti-GAD65, anti-IA-2, anti-ZnT8 and, where appropriate, insulin autoantibodies.

The results must be interpreted by a specialist endocrinologist, who will assess whether the patient meets the diagnostic criteria for type 1 diabetes and whether follow-up or repeat screening is necessary over time. Interpreting the results makes it possible to determine whether there is evidence of autoimmunity associated with type 1 diabetes.

If positive autoantibodies are detected, the specialist will assess the need to confirm the results and perform additional tests, including glucose testing, to establish the stage of the disease.

What happens if the screening result is positive?

A positive result does not necessarily mean that the person has clinical diabetes or needs to start insulin treatment immediately.

The assessment process may include:

1. Autoantibody confirmation: verifying the markers detected and assessing their clinical significance.

2. Blood glucose assessment: determining whether there are any abnormalities in glucose metabolism.

3. Disease staging: establishing whether the person has presymptomatic type 1 diabetes at stage 1 or 2, or meets the criteria for clinical diabetes.

4. Follow-up and treatment assessment: defining the necessary monitoring and evaluating the available options according to the disease stage and the patient's individual characteristics.

This process enables personalised care and helps anticipate disease progression.

The implementation of type 1 diabetes screening programmes  within the public healthcare system is still under development. Currently, barnaclínic+ is one of the few healthcare institutions offering accessible, personalised screening with rapid results.

At barnaclínic+, you can choose the screening option that best suits your needs:

· In-person screening at our centre

A blood sample is collected at our facilities and analysed for autoantibodies associated with type 1 diabetes, with specialist interpretation of the results.

· At-home self-sampling screening

We also offer the option of screening using an at-home self-sampling kit, without the need to travel to our centre.

Our team arranges the delivery of the kit and collection of the sample for subsequent analysis. The results are accompanied by a medical assessment, which can be carried out in person or through an online consultation.

Early detection of type 1 diabetes makes it possible to identify an autoimmune process before symptoms appear and arrange medical monitoring tailored to each person's individual risk.

Its main benefits include:

· Identifying type 1 diabetes before its clinical onset, even when no symptoms are present.

· Reducing the risk of diabetic ketoacidosis at diagnosis, through monitoring and early identification of disease progression.

· Establishing specialist follow-up, with monitoring tailored to the disease stage and individual risk.

· Preparing patients and their families to recognise the first symptoms and understand how the disease progresses.

· Identifying potential candidates for new therapies, such as teplizumab, which can delay the progression of type 1 diabetes in selected patients at stage 2.

Screening does not, in itself, prevent the onset of type 1 diabetes, but it provides information that can significantly change how the early stages of the disease are managed.

"We have a unique window of opportunity to change the natural course of type 1 diabetes."

Dr. Jesús Blanco, endocrinologist at barnaclínic+

At barnaclínic+, we offer a comprehensive, precise and personalised approach to type 1 diabetes screening and early diagnosis.
Our endocrinology team from Hospital Clínic de Barcelona, an international leader in diabetes research, actively participates in early detection and diagnosis programmes, applying the most up-to-date diagnostic criteria for diabetes.

At the barnaclínic+ type 1 diabetes screening programme, we offer a comprehensive process that combines scientific rigour, technological innovation and personalised care:

A compassionate, patient-centred approach

We support you throughout every stage of the screening process with personalised care, clinical advice and guidance for you and your family.
Our aim is to provide reassurance and clear information to people who wish to undergo a type 1 diabetes screening test or understand their risk of developing the condition.

Precision screening and diagnosis

We perform type 1 diabetes screening tests using highly sensitive immunological tests that detect the presence of specific autoantibodies before symptoms appear.
These tests enable us to establish an early diagnosis of diabetes and plan follow-up for each patient according to their individual risk.

Advanced technology and testing

We have specialised laboratories and state-of-the-art technology for the early detection of type 1 diabetes.
Our systems allow us to analyse several autoimmune markers and correlate them with other genetic or clinical factors, providing a more comprehensive and reliable diabetes diagnosis.

Expert multidisciplinary team

Our type 1 diabetes screening programme brings together endocrinologists, immunologists, dietitians and diabetes educators from Hospital Clínic, who work together to provide early diagnosis and comprehensive follow-up for each person at risk.

Innovation and scientific collaboration

barnaclínic+ participates in international type 1 diabetes screening programmes and research projects investigating new biomarkers and immunomodulatory treatments aimed at modifying the course of the disease.

This experience allows us to bring scientific advances into clinical practice, from diagnosing type 1 diabetes in its presymptomatic stages to assessing new therapeutic options such as teplizumab in patients who meet the eligibility criteria.

Diagnosis and follow-up in one place

In one location, we provide testing, interpretation of results, medical advice and follow-up planning, avoiding unnecessary travel and ensuring continuity of care.
The entire diabetes screening process is coordinated at barnaclínic+, from sample collection to risk assessment and final diagnosis.

Which antibodies are tested during type 1 diabetes screening?

Up to four are typically tested: GAD65, IA-2, ZnT8 and insulin autoantibodies.

What does it mean to test positive for diabetes autoantibodies without having symptoms?

It indicates an increased risk of developing type 1 diabetes, even if the diagnostic criteria for diabetes have not yet been met. The specialist will establish a personalised follow-up plan.

Do I need to fast before the blood test for early diabetes diagnosis?

No. The blood sample can be taken without fasting.

Can I have the screening test even if I have no family history of type 1 diabetes?

Yes, although current recommendations primarily focus on first-degree relatives. In the coming years, diabetes screening is expected to expand to the general population.

Can I undergo screening even if I have no symptoms?

Yes. In fact, screening is specifically intended for people who do not have symptoms of type 1 diabetes.

If symptoms such as excessive thirst, increased urine output, unexplained weight loss or significant fatigue are already present, a medical assessment and diagnostic blood glucose tests are necessary, rather than waiting for an autoantibody screening test.

What is teplizumab?

Teplizumab (Teizeild®) is an immunotherapy designed to modify the immune response involved in the destruction of pancreatic beta cells. It is authorised to delay progression from stage 2 to stage 3 type 1 diabetes in selected patients.

Who is eligible for teplizumab treatment?

Teplizumab is authorised in the European Union for adults and children aged 8 years and older with stage 2 type 1 diabetes. A specialist assessment is required to confirm the stage of the disease and determine whether the patient meets the eligibility criteria for treatment.

Does teplizumab cure type 1 diabetes?

No. Teplizumab does not cure type 1 diabetes or permanently prevent its onset. Instead, it can delay progression from stage 2 to stage 3, or clinical diabetes.

How is teplizumab administered?

Treatment consists of a course of intravenous infusions administered over 14 consecutive days under specialist medical supervision.

Why is screening important for access to teplizumab treatment?

Teplizumab is indicated before the onset of clinical type 1 diabetes, specifically in patients at stage 2. Therefore, type 1 diabetes screening and early diagnosis are essential to identify people who may benefit from an assessment for this treatment.

Where can I receive teplizumab treatment?

At barnaclínic+, we provide specialist assessments for patients with stage 2 type 1 diabetes to determine the available monitoring and treatment options, including whether teplizumab may be indicated.