Over the past decade there has been a drive towards prevention of type 1 diabetes (T1D), which has led to the development of screening programmes to identify individuals with early-stage disease. In the same period, clinical trials have been taking place on the use of immunotherapy in preventing T1D progression. These developments in screening and immunotherapy require care pathways that provide monitoring, information and support to children and young people with early-stage type 1 diabetes and their families. This article provides an overview of the developments in screening and immunotherapy and considers the implications for children and young people and their families and for the healthcare professionals involved in their care.