Population-wide screening for early stages of type 1 diabetes in regular pediatric care is permanently feasible and detects the majority of future cases of the disease at an early stage. This is shown by the results of the Fr1da study, which has been running since 2015 and led by Helmholtz Munich and has now been published in the journal “JAMA”.

In Bavaria, more than 220,000 children have so far been tested for islet autoantibodies as part of normal pediatrician visits. A total of 716 paediatricians in private practice took part in the programme. 590 children (0.3 percent) were found to have an early stage (stage 1 or 2). Of these, 212 later developed clinical type 1 diabetes (stage 3). This corresponds to 81 percent of all children in whom the disease became manifest during the observation period.

The study refutes the assumption that screening only makes sense for children with a family history. The majority of children who developed type 1 diabetes had no first-degree relatives with the condition. A second screening after about three years proved valuable: It identified 29 more cases in children who were initially inconspicuous.

Progression from an early stage into manifest diabetes occurs at a relatively constant rate of about 20 percent per year. This underlines the benefits of early detection: families can be trained, children can be closely cared for and life-threatening diabetic ketoacidosis can be largely avoided.

“The data clearly show that screening in the general population is sensible and feasible,” explained Dr. Christiane Winkler, head of the Fr1da team at Helmholtz Munich. Prof. Anette-Gabriele Ziegler, Director of the Institute of Diabetes Research at Helmholtz Munich, added: “The disease process is comparable in children with and without a family history. Therefore, such screening should be offered to all children in the future.”

The Fr1da study also provides important foundations for the development and testing of new disease-modifying therapies that could delay or prevent the onset of type 1 diabetes. The results strengthen the arguments for integrating screening into standard care.

Original Paper:

Winkler et al., 2026: Screening Children for Early-Stage Type 1 Diabetes. JAMA. DOI: 10.1001/jama.2026.6085

Editor: X-Press Journalistenbüro GbR

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