Professional Stakeholders' Perspectives on Early Screening for Type 1 Diabetes in Children: A Systematic Review

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Abstract
Early screening for type 1 diabetes (T1D) is receiving increasing attention as presymptomatic screening initiatives and disease‐modifying therapies continue to expand. However, the perspectives of professional stakeholders, who play a pivotal role in implementation, patient engagement, and health system preparedness, have not been systematically synthesised. We conducted a systematic review to examine professional views on paediatric early T1D screening. Following PRISMA guidelines, six databases (Medline, Embase, Scopus, CINAHL, PsycINFO, ASSIA) and grey literature were searched through January 2026. Twelve studies met the inclusion criteria, predominantly involving paediatricians and diabetes specialists; nurses, genetic counsellors, policymakers, and other healthcare professionals were represented in few studies. Methodological appraisal using the Mixed Methods Appraisal Tool (MMAT) identified recurring limitations in sample representativeness and potential nonresponse bias. Given the heterogeneity and primarily descriptive nature of the study design and outcomes, findings were synthesised narratively. Professional perspectives varied according to the population targeted, professional group studied, screening scenario, and the implementation context. Where directly compared, support was greater for at‐risk than for general‐population screening. Reported benefits included diabetic ketoacidosis (DKA) prevention, earlier clinical engagement, and improved preparedness for families. However, concerns persisted regarding psychosocial burden, workforce capacity, and unclear referral and follow‐up pathways. More favourable evaluations were reported in some structured programmes, although these findings may reflect reliance on existing infrastructures and targeted participant selection. By consolidating previously fragmented evidence, this review identifies recurring clinical, psychosocial, and organisational considerations relevant to paediatric T1D screening. These findings primarily reflect clinical perspectives and indicate conditional rather than uniform support. Further studies should evaluate how standardised pathways, professional training, and integrated psychosocial support affect the feasibility and acceptability of screening across different healthcare contexts.

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