Millions worldwide live with type 1 diabetes, and for most the diagnosis came as a shock, following mysterious symptoms such as thirst and weight loss. But diabetes specialists have long known that certain blood tests can foretell the disease years earlier. That has left the field wrestling with a difficult question: Should healthy children get these blood tests, and would knowing about incipient diabetes help them?
One project, in Germany, screened tens of thousands of children and tracked those who tested positive. It found that among 118 who progressed to full-blown diabetes, the rate of DKA was just 2.5%.
In Colorado, a similar project recorded a DKA rate of about 4%, less than one-tenth of the usual prevalence there, says Marian Rewers, the project leader and a pediatric endocrinologist at the University of Colorado’s Barbara Davis Center for Diabetes.