Most screening programs to identify individuals at risk for type 1 diabetes have targeted relatives of people living with the disease to improve yield and feasibility. However, ∼90% of those who develop type 1 diabetes do not have a family history. Recent successes in disease-modifying therapies to impact the course of early-stage disease have ignited the consideration of the need for and feasibility of population screening to identify those at increased risk. Existing population screening programs rely on genetic or autoantibody screening, and these have yielded significant information about disease progression and approaches for timing for screening in clinical practice. At the March 2021 Type 1 Diabetes TrialNet Steering Committee meeting, a session was held in which ongoing efforts for screening in the general population were discussed. This report reviews the background of these efforts and the details of those programs. Additionally, we present hurdles that need to be addressed for successful implementation of population screening and provide initial recommendations for individuals with positive screens so that standardized guidelines for monitoring and follow-up can be established.

中文翻译：

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在普通人群中筛查 1 型糖尿病：现状报告和展望。

大多数识别 1 型糖尿病风险个体的筛查计划都针对患有这种疾病的人的亲属，以提高产量和可行性。然而，约 90% 的 1 型糖尿病患者没有家族史。最近在影响早期疾病进程的疾病修正疗法方面取得的成功引发了人们对人群筛查以确定风险增加人群的必要性和可行性的考虑。现有的人群筛查计划依赖于基因或自身抗体筛查，这些已经产生了关于疾病进展的重要信息和临床实践中筛查时机的方法。在 2021 年 3 月的 1 型糖尿病 TrialNet 指导委员会会议上，举行了一次会议，讨论了正在进行的普通人群筛查工作。本报告回顾了这些努力的背景和这些计划的细节。此外，我们提出了成功实施人群筛查需要解决的障碍，并为筛查结果呈阳性的个人提供初步建议，以便建立标准化的监测和随访指南。