Type 1 diabetes: paediatric screening and treatment to delay its onset
In stage 2 of the disease, screening and immunomodulatory monoclonal antibodies to prevent complications and keep costs down for the National Health Service
Key points
The multi-year, nationwide screening programme for the paediatric population to detect autoantibodies associated with type 1 diabetes (T1DM) and coeliac disease (Ministry of Health Decree of 7 August 2026, implementing Law No. 130/2023) was published in the Official Gazette No. 234 of 8 October 2026. The stated objective for diabetes is to prevent the onset of ketoacidosis (a serious complication) and to slow the progression of the disease through the use of available treatments.
A profile of the disease
T1DM is a chronic autoimmune condition characterised by the progressive (pre-insulinopathic) destruction of the beta cells in the pancreas, resulting in a deficiency in insulin secretion, eventually leading to its complete absence: the deficiency of this hormone, which is essential for regulating blood glucose levels, necessitates insulin replacement therapy (stages 3–4 of the disease). The main biomarker for T1DM is the presence in the blood of autoantibodies directed against these pancreatic cells: the presence of two or more autoantibodies, when associated with dysglycaemia, indicates that a child is at high risk of disease progression and should be treated with medication to delay the onset of the disease.
Free paediatric screening
In Italia, an estimated 300,000 people (around 10 per cent of diabetes cases) have T1DM, which is the most common form of the disease in the paediatric population. The early identification of young people at risk of developing stage 2 T1DM is therefore of significant clinical importance: Italia is the first country in the world to introduce a free national paediatric screening programme.
In order to assess the applicability, acceptability and sustainability of this screening within the National Health Service, the “D1Ce Screen” pilot project was launched, coordinated by the Istituto Superiore di Sanità (ISS) and carried out in Campania, Lombardy, Marche and Sardinia.
The results of the trial highlighted a high level of willingness to participate on the part of both families and paediatricians chosen by patients, whilst also enabling the identification of children at risk (the 5–6-year-old age group specified in the Ministerial Decree), who were subsequently referred to regional specialist centres for further diagnostic investigations and follow-up.
