Should we test routinely for autoimmunity among children with newly diagnosed type 1 diabetes mellitus?

All tests have costs, not just financial, but also attitudinal, in shaping future behaviors of patients, their family members, and healthcare personnel.There could be changes in actions taken, including getting more tests or implementing measures for risk reduction, and emotional reactions, including higher anxiety levels, or complacency and reduced adherence to future necessary actions.Therefore, in an ideal world where wastage is abhorred, whenever a test is ordered, the health care team should be aware of these factors, be sure it is money well spent, and be clear about what it intends to do with the test results.For example, there is a strong case for universal screening of thyroid function in newborns, with reasonable clarity about what to do with the reports.About 98-99% newborns would be considered normal; the very few with abnormal reports would be advised confirmatory retesting; and the one in 1,000-3,000 affected newborns would be started on thyroxine replacement so that brain development is not hampered, and intellectual disability is prevented.It is another matter that this screening still eludes over 70% newborns worldwide.