[Personal View] Managing adults with screen-detected islet autoantibody positivity: a pragmatic framework

New disease-modifying therapies, such as teplizumab, offer opportunities to delay the clinical onset of type 1 diabetes but require islet autoantibody screening to identify individuals at increased risk of progression to diabetes. As type 1 diabetes screening programmes expand, clinicians will increasingly encounter a new group of people: adults who test positive for islet autoantibodies but have not yet been diagnosed with diabetes. Although international guidelines outline management for both children and adults, considerable uncertainties remain, particularly for adults.