Type 1 diabetes is a multifactorial disease of complex etiology characterized by the autoimmune destruction of pancreatic beta cells. In addition to genetic susceptibility, it is generally accepted that environmental factors such as virus infection may play important roles in triggering disease. The recent availability of novel immunomodulatory therapies that may preserve residual beta cell mass in new onset diabetics has generated a demand for noninvasive testable biomarkers that can identify the development of the autoreactive process before it becomes clinically apparent.