Polish Recommendations for the Early Detection of Type 1 Diabetes in the Pediatric Population: A Position Statement of the Polish Society of Pediatric Endocrinology and Diabetology and the Pediatric Section of the Diabetes Poland 2026

Recent advances in the understanding of the natural history of type 1 diabetes (T1D), together with the availability of disease-modifying therapies, have fundamentally changed the rationale for early detection of this disease. T1D is a common autoimmune disorder with rapidly increasing incidence among Polish children, particularly in the youngest age groups, and is still frequently diagnosed at the stage of diabetic ketoacidosis (DKA), which carries significant short- and long-term morbidity. The document summarizes current evidence supporting screening based on the detection of islet autoantibodies (GADA, IA-2A, ZnT8A, and IAA), reviews international and national screening programs, and outlines the clinical, psychological, and economic benefits of early identification, including a marked reduction in DKA at diagnosis. Definitions of T1D stages, diagnostic criteria, and risks of progression are described, along with practical algorithms for confirmatory testing, referral, and follow-up. Particular attention is given to screening strategies in both high-risk groups and the general pediatric population, recommended ages for screening, and principles of longitudinal monitoring. These recommendations, developed by national experts, are intended to support the implementation of structured early detection programs and to improve outcomes for children at risk of or living with preclinical T1D within the Polish healthcare system.