Screening children for type 1 diabetes-associated antibodies at community health fairs

Pediatr Diabetes. 2019 Nov;20(7):909-914. doi: 10.1111/pedi.12902. Epub 2019 Aug 18.


Objective: The incidence of type 1 diabetes (T1D) is increasing, most notably in young children and in racial and ethnic minorities. Historically, screening for risk with T1D-associated antibodies has been limited to those with a family history, while up to 90% of newly diagnosed patients lack such a family history. To address the needs to screen diverse ethnic groups in the general population, we screened children for T1D-associated antibodies in the Denver, Colorado metro area at community health fairs.

Methods: Children attending health fairs from 2015 to 2018 were offered free T1D screening by measuring the four prototypical T1D-associated antibodies. A finger stick capillary puncture was performed to collect blood spots on filter paper. Dried blood spots (DBSs) were eluted and antibodies were measured using fluid-phase radio-binding assays.

Results: At 39 health fairs, children were educated on the signs and symptoms of diabetes, and screened for T1D-associated antibodies (n = 478), which represented 90% of those that attended. Median age was 9.0 years (range of 1-18) with diverse ethnic backgrounds: 37% Hispanic, 31% Caucasian, 20% African American, and 12% other. Nine children screened positive for antibodies, single n = 8 and multiple n = 1, and confirmation with serum samples showed excellent correlation to the measurements from DBSs for antibodies directed against GAD, IA-2, and ZnT8 (P < .01 for each).

Conclusions: Screening for T1D risk at community health fairs using DBSs on filter paper is feasible and provides an avenue to screen children from ethnically diverse backgrounds.

Keywords: children; health fairs; islet autoantibodies; screening; type 1 diabetes.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Autoantibodies / analysis
  • Autoantibodies / blood*
  • Blood Specimen Collection / methods
  • Child
  • Child, Preschool
  • Colorado / epidemiology
  • Community Health Services / methods
  • Community Health Services / organization & administration
  • Community Health Services / statistics & numerical data
  • Diabetes Mellitus, Type 1 / blood
  • Diabetes Mellitus, Type 1 / diagnosis*
  • Diabetes Mellitus, Type 1 / epidemiology
  • Diabetes Mellitus, Type 1 / immunology
  • Diagnostic Techniques, Endocrine
  • Female
  • Health Fairs / methods*
  • Health Fairs / statistics & numerical data
  • Humans
  • Infant
  • Islets of Langerhans / immunology
  • Male
  • Mass Screening / methods*
  • Mass Screening / statistics & numerical data


  • Autoantibodies