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Diabetes is a leading chronic childhood disease affecting 1 in 300 children. Current immunogenetic tests can predict most future cases. Most cases of Type 1 Diabetes are in children without a close relative with the disease, therefore all children must be tested. Building on the success of our original DEW-IT and TEDDY diabetes studies, we received funding from Washington State (Life Sciences Discovery Fund) to show that it is possible and affordable to integrate Type 1 Diabetes genetic screening into the Washington State Department of Health Newborn Screening Program on leftover blood already taken for the state PKU. Additionally, we want to involve the state's physicians in follow-up islet antibody surveillance on those children at the highest genetic risk.