Optimising childhood diabetes screening

Type 1 diabetes (T1D) often begins silently in childhood. Many children are diagnosed only when they develop diabetic ketoacidosis (DKA), a life-threatening emergency that can have long-term health consequences and high hospital costs. In some regions, up to 60% of children present with DKA at diagnosis.

This study developed a computer simulation model to test different ways of screening children for early, pre-symptomatic T1D using genetic risk scores and islet autoantibody tests. Instead of testing one strategy at a time, the model used advanced optimisation to balance three goals: reducing severe DKA events, limiting healthcare visits, and keeping costs reasonable.

The results show that certain targeted screening strategies could be cost-effective in the USA and reduce severe complications at diagnosis. This is important because smarter screening could improve children’s safety, reduce emergency admissions, and help health systems use resources more efficiently.

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Citation:

Leiria, G., McQueen, R.B., Jackson, C. et al. Development of a Patient-Level Multi-objective Optimisation Model for Screening Strategies for Childhood Type 1 Diabetes. PharmacoEconomics (2026). https://doi.org/10.1007/s40273-025-01581-1

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