A new approach to predicting which babies will develop type 1 diabetes moves a step closer to routine testing for newborns which could avoid life-threatening complications. Scientists at seven international sites have followed 7,798 children at high risk of developing type 1 diabetes from birth, over 9 years, in The Environmental Determinants of Diabetes in the Young (TEDDY) Study. The TEDDY Study is a large international study funded primarily by the US National Institutes of Health and US Centers for Disease Control, as well as by the charity JDRF. Scientists at the University of Exeter and the Pacific Northwest Research Institute in Seattle used the TEDDY data to develop a method of combining multiple factors that could influence whether a child is likely to develop type 1 diabetes.1 The combined risk score approach incorporates genetics, clinical factors such as family history of diabetes, and their count of islet autoantibodies—biomarkers known to be implicated in type 1 diabetes. The research team found that the new combined approach dramatically improved prediction of which children would develop type 1 diabetes, potentially allowing better diabetes risk counseling of families. Most importantly, the new approach doubled the efficiency of programs to screen newborns to prevent the potentially deadly condition of ketoacidosis, a consequence of type 1 diabetes in which insulin deficiency causes the blood to become too acidic. Identifying which children are at highest risk will also benefit clinical trials on drugs that are showing promise in preventing the condition. “At the moment, 40% of children who are diagnosed with type 1 diabetes have the severe complication of ketoacidosis. For the very young this is life-threatening, resulting in long intensive hospitalizations and in some cases even paralysis or death,” says Lauric Ferrat, PhD, at the University of Exeter Medical School. “Using our new combined approach to identify which babies will develop diabetes can prevent these tragedies, and ensure children are on the right treatment pathway earlier in life, meaning better health.” Reference 1. Ferrat LA, Vehik K., Sharp SA,et al. A combined risk score enhances prediction of type 1 diabetes among susceptible children. Nat Med. Epub  August 7, 2020. doi: 10.1038/s41591-020-0930-4.