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Definitive prevention for type 1 diabetes (T1D) is not yet available, but we are now entering a new era where disease-modifying therapies are becoming available in T1D to halt disease progression. In this review, we present up-to-date knowledge related to the prevention of T1D in youth, involving disease-modifying therapies at different T1D stages. A narrative literature review utilising the PubMed/MEDLINE database was performed using the keywords 'screening', 'prevention', 'Disease-modifying therapy', and 'Diabetes Mellitus, Type 1' [Mesh] in youth aged 0-18 years. Only teplizumab has been approved by the FDA as the first drug shown to delay the onset of Stage 3 T1D. Other monoclonal antibodies targeting specific immune cells, agents targeting specific cytokines, antigen-specific therapies, and immunomodulant and/or immunosuppressive agents have been studied alone or in combination to control or delay the progression of beta-cell destruction. In individuals with Stage 3 T1D, several intervention trials have led to a temporary improvement in beta-cell function, but this benefit has consistently been short-lived. Ongoing and future research will be essential to refine patient selection, identify additional therapeutic targets, and optimise the timing and durability of immunotherapy responses.