Autoimmune type 1 diabetes diagnosis

Diagnosis of autoimmune type 1 diabetes usually happens once the disease has progressed into high blood glucose or even a medical emergency when left untreated.

Early detection of autoimmune type 1 diabetes provides a better way to be introduced to living with the condition,⁴ putting you in the driver’s seat. Screening is a proactive way to detect and manage type 1 diabetes, helping you look after your health at every stage of the journey.⁴

An early diagnosis of autoimmune type 1 diabetes allows you to learn more about the condition and how to confidently manage it before the onset of symptoms. This knowledge eases worry and distress when autoimmune type 1 diabetes progresses to later, symptomatic stages.⁴ Discover what happens after screening.

In autoimmune type 1 diabetes, the body's immune cells produce antibodies mistakenly against the insulin-producing cells (beta cells) in the pancreas. These so-called autoantibodies can appear years before the first symptoms emerge.

The detection of autoantibodies through screening allows doctors to identify people who have a higher chance of developing autoimmune type 1 diabetes.² In particular, individuals with relatives who have autoimmune type 1 diabetes are up to 15 times more likely to develop the condition and are recommended to be screened.⁴

Calculate your risk of autoimmune type 1 diabetes.

Screening can detect autoimmune type 1 diabetes early, but further tests are needed to firmly diagnose the condition and identify the stage at which people are.⁵

Learn more about screening in autoimmune type 1 diabetes.

In autoimmune type 1 diabetes, the body's immune cells produce antibodies mistakenly against the pancreas.² These so-called autoantibodies can appear years before the first symptoms emerge.

The detection of these autoantibodies through screening allows doctors to identify people who have a higher chance of developing autoimmune type 1 diabetes.² In particular, individuals with a relative with autoimmune type 1 diabetes have an increased likelihood of developing autoimmune type 1 diabetes and are recommended to be screened.^1,6

Doctors also use screening for autoantibodies to confirm a suspected type 1 diabetes diagnosis, because high blood glucose levels alone are not enough for a firm type 1 diabetes diagnosis..⁷

However, screening may not always find autoantibodies - 90% of relatives of people with autoimmune type 1 diabetes will not show any detectable autoantibodies.⁴

Learn more about screening in T1D.

Autoimmune type 1 diabetes can cause a wide range of symptoms, including unexplained weight loss, frequent urination, and increased thirst and tiredness.^2,3

These symptoms play an important role in the diagnosis of symptomatic type 1 diabetes patients, however, it’s also now possible to detect autoimmune type 1 diabetes before the onset of symptoms through screening.⁴

Screening for type 1 diabetes autoantibodies is a key test to detect autoimmune type 1 diabetes.⁵ Autoantibody tests detect autoantibodies that the body mistakenly produces against insulin-producing beta cells in the pancreas.²

In addition to autoantibody testing, other tests are used to determine the stage of autoimmune type 1 diabetes.⁶ Your doctor might conduct the following tests to determine the stage:

The HbA1c test determines the average blood glucose levels of the past 3 months. An HbA1c level between 5.7 –6.4% indicates stage 2 autoimmune type 1 diabetes, while a value of or above 6.5% suggests stage 3. People with autoimmune type 1 diabetes will need to get familiar with their A1C level because regular HbA1c assessments are used to monitor the disease and adjust treatment when necessary.^6,7

This test measures blood glucose levels after at least 8 hours without food and drink except for water. In the case of autoimmune type 1 diabetes, a blood glucose value between 100 –125 mg/dL is usually associated with stage 2, while 126 mg/dL or more in repeated fasting blood glucose tests indicates stage 3.^6,8

The oral glucose tolerance test assesses blood glucose before and after a medical glucose drink. In the case of autoimmune type 1 diabetes, a value between 140 –199 mg/dL 2 hours after the drink is consumed points to stage 2, while a value of at least 200 mg/dL suggests stage 3.^6,8

This test measures blood glucose at any time of the day. Blood glucose levels are determined at random with this test. In the case of autoimmune type 1 diabetes, values at or above 200 mg/dL indicate stage 3.⁸

Autoimmune type 1 diabetes can be detected years before a diagnosis is made. Currently, the most common age for an autoimmune type 1 diabetes diagnosis is between 10-14 years old.⁹ However, it is now widely recognised that adults get it too, with up to 62% of new autoimmune type 1 diabetes cases occurring in adulthood.

Autoimmune type 1 diabetes can affect anyone at any age.¹⁰ In most cases, type 1 diabetes autoantibodies show the first peak between 9 months and 2 years.¹¹

To detect autoimmune type 1 diabetes as early as possible, screening for autoimmune type 1 diabetes should therefore be done in young children, ideally at the ages of 2 and 6.¹² In addition, individuals with a higher chance of developing type 1 diabetes are recommended to be screened. This group includes people with a family history of type 1 diabetes and those with certain autoimmune diseases.⁴

Calculate your risk of autoimmune type 1 diabetes.

Autoimmune type 1 diabetes can be diagnosed at any stage of life. Some people are first diagnosed with autoimmune type 1 diabetes in their 50s and 60s.^2,13

Adult patients are often diagnosed at a late stage when symptoms emerge and sometimes become a medical emergency.^2,14 Screening for autoimmune type 1 diabetes can help reduce the likelihood of these medical emergencies.¹⁴ In particular, people with a family history of autoimmune type 1 diabetes or other autoimmune diseases are recommended to be screened.¹⁵ However, the majority of individuals with autoimmune type 1 diabetes do not have a family history of the condition.¹⁵

Talk to a healthcare professional about screening if you suspect that you or your loved ones might be at risk of developing autoimmune type 1 diabetes.

Learn more about risk factors for autoimmune type 1 diabetes.

A misclassification is possible and mostly occurs in adults over 30 years old.⁵ Autoimmune type 1 diabetes and prediabetes cause similar high blood glucose levels, making it difficult to distinguish the two conditions at this stage.⁶

Autoimmune type 1 diabetes can also be misdiagnosed as type 2 diabetes, as both conditions cause similar symptoms.^13,16 Around 77% of adults with autoimmune type 1 diabetes are initially misdiagnosed with type 2 diabetes.^17,18

While it’s easy to confuse them, they are completely different. Prediabetes is a condition that precedes type 2 diabetes and can be reversed by diet and exercise, whereas autoimmune type 1 diabetes cannot be stopped or reversed. This is because, unlike autoimmune type 1 diabetes, prediabetes and type 2 diabetes are not autoimmune conditions

Testing for autoantibodies can distinguish type 1 diabetes from type 2 diabetes⁸ and reduce the chance of misclassification.⁴

Uncover other common autoimmune type 1 diabetes myths.

It is normal to feel surprised or scared by a new type 1 diabetes diagnosis and to have a lot of questions. Your healthcare team is there to provide education and resources that will empower you to take control of your health with confidence and support.⁴

There is currently no cure for autoimmune type 1 diabetes, however, new treatments are constantly being developed, making it easier to manage the condition.⁴

If screening has detected that you may be in the presymptomatic stages of autoimmune type 1 diabetes, then you and your doctor will keep track of the progression of your condition by monitoring changes in blood glucose levels. No insulin therapy is needed at this stage.^5,18 In the early, presymptomatic stages, education and psychological support can help prepare you for the journey ahead.⁴ There are treatment options that can potentially be used to delay the onset of stage 3 autoimmune type 1 diabetes.⁴

Learn more about what comes next after screening.

If you’re in the symptomatic, clinical stage of autoimmune type 1 diabetes, current management approaches include taking insulin and regular monitoring of blood sugar.^5,19 In addition to insulin therapy, exercise, lifestyle changes, and support services can empower you to confidently manage the disease and your well-being.⁵