Early Screening for Type 1 Diabetes Shows Promise in Bulgaria—and Could Help Prevent Emergencies

Type 1 diabetes can develop suddenly, sometimes with life-threatening symptoms like diabetic ketoacidosis (DKA) at the time of diagnosis. But research shows that the disease doesn't appear overnight—it builds over time as the immune system gradually attacks insulin-producing cells in the pancreas.

By screening children for islet autoantibodies (proteins that mark this immune attack), doctors may be able to identify risk before symptoms start. This gives families time to prepare, seek care quickly if symptoms emerge, and potentially access disease-modifying therapies that can slow progression.

Researchers in Bulgaria recruited 210 children (84% of their target of 250) between October 2024 and February 2026. Of these, 160 had a relative with type 1 diabetes, and 50 had no family history. All participants were screened for five different islet autoantibodies using specialized blood tests.

Among the 160 children with a family history, seven (4.4%) tested positive for one autoantibody—but importantly, no child showed multiple autoantibodies or advanced stages of the disease. Among the 50 children without a family history, none tested positive for any autoantibodies.

This pilot study shows that selective screening of high-risk children—those with a relative with type 1 diabetes—is practical and can be done in regular healthcare settings. Children who test positive for autoantibodies are then scheduled for follow-up monitoring to track whether autoimmunity persists or progresses.

Finding these markers early doesn't mean a child will definitely develop type 1 diabetes, and it's not a diagnosis in itself. But it does provide valuable information that can help families understand their child's risk and work with their healthcare team to watch for early warning signs.

The children who tested positive in this study are continuing to be monitored for immune and metabolic changes. This follow-up data will help researchers understand how quickly autoimmunity leads to diabetes and whether early screening truly helps prevent complications like DKA.

While this is an early-stage pilot study in one country, it adds to growing evidence that screening can be a practical tool for identifying children at highest risk and potentially opening doors to early intervention strategies.

Source: Journal of clinical medicine. 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.