This prospective cohort study aimed to evaluate the effectiveness of islet autoantibody screening in at-risk adolescents to predict the development of type 1 diabetes (T1D) until young adulthood. Type 1 diabetes is a chronic autoimmune disease that primarily affects young individuals and requires lifelong management of blood glucose levels. Early detection of T1D can facilitate timely intervention and improve health outcomes. A total of 500 at-risk adolescents were recruited based on genetic predisposition and family history and were regularly screened for islet autoantibodies [1, 2], including glutamic acid decarboxylase antibodies (GADA), insulinoma antigen-2 antibodies (IA-2A), and insulin autoantibodies (IAA). The screening process began during adolescence and continued until young adulthood. Among the cohort, 80 participants tested positive for one or more islet autoantibodies. Of these, 65 individuals (81.25%) progressed to clinical T1D during young adulthood, while the remaining 15 participants (18.75%) maintained normal glucose tolerance, suggesting immune tolerance in some at-risk individuals [3]. The median time from the detection of islet autoantibodies to clinical T1D onset was 3.5 years. Subgroup analysis indicated that participants with two or more positive autoantibodies had a significantly higher risk of developing T1D compared to those with only one positive autoantibody [4].
