Age < 15 years
• Currently low risk
• Consider repeat Ab screen
at recommended intervals**
Age ≥ 15 years
• Low risk
• No repeat screen unless
symptoms present
• If you have a family member
with T1D, consider repeat
screening after the age of 18yrs
**Recommended screening "windows"
ages 1-3, 4-6, 9-11. If family history of
T1D or medical history of autoimmune
disease, consider yearly screen.
* When possible, test a second sample from venous blood in a laboratory that meets IASP standards using a different assay method. Where a two-test confirmation is not possible, a single blood test positive for multiple islet autoantibody status identifies a person with sufficient risk for metabolic monitoring.
​
Ask the Experts can provide confirmation testing.
Please contact us for additional information.
POSITIVE for ≥1 Ab
CONFIRM with Ab testing *
Obtain Random Blood Glucose (RBG) and HbA1c
CONFIRMATION
CONFIRMATION
NEGATIVE
Normal RBG <140 mg/dL
and HbA1c ≤ 5.6%
RBG 140-199 mg/dL
OR HbA1c 5.7-6.4%
RBG ≥ 200 mg/dL
OR HbA1c ≥ 6.5
FOLLOW-UP
Initial screen positive for 1 Ab and age < 15 years
• Repeat Ab at reference lab
at recommended intervals**
Initial screen positive for 1 Ab and age ≥ 15 years
• Low risk
• No repeat screen unless
symptoms present
​
Initial screen positive for ≥ 2 Ab
• Educate for symptoms of
hyperglycemia
• Repeat Ab at reference lab
in 1 year
RBG <140mg/dL OR HbA1c ≤ 5.6%
• Assess patient for T2D risk
factors (BMI, family history
of T2D, ethnicity)
​
• Assess/Educate for
symptoms of hyperglycemia
​
• Age <18 years: Refer to
pediatric diabetologist for
further evaluation
(T1D vs T2D vs MODY)
​
• Age ≥18 years: Consider
referral to endocrinologist
for further evaluation
(T1D vs T2D vs MODY)
RBG 140-199mg/dL OR HbA1c 5.7-6.4%
RBG ≥ 200mg/dL OR HbA1c ≥6.5
• Evaluate for symptoms
of hyperglycemia and
ketosis***
• Verbal consult with
and urgent referral to
pediatric/adult diabetologist
Ask the Experts can provide confirmation testing. Please contact us for additional information.
**Recommended screening "windows" ages 1-3, 4-6, 9-11. If family history of T1D or medical
history of autoimmune disease, consider yearly screen.
***Ketosis symptoms: vomiting, nausea, abdominal pain, Kussmaul breathing, altered mental
status. If concern for ketosis, check urine or blood ketones if able, if positive or unable to test
refer for urgent evaluation at ED.
Ab: Antibody
BMI: body mass index
MODY: maturity onset diabetes of the young
RBG: random blood glucose
T1D: type 1 diabetes
T2D: type 2 diabetes