Staging presymptomatic type 1 diabetes: a scientific statement of JDRF, the Endocrine Society, and the American Diabetes Association

Diabetes Care. 2015 Oct;38(10):1964-74. doi: 10.2337/dc15-1419.

Abstract

Insights from prospective, longitudinal studies of individuals at risk for developing type 1 diabetes have demonstrated that the disease is a continuum that progresses sequentially at variable but predictable rates through distinct identifiable stages prior to the onset of symptoms. Stage 1 is defined as the presence of β-cell autoimmunity as evidenced by the presence of two or more islet autoantibodies with normoglycemia and is presymptomatic, stage 2 as the presence of β-cell autoimmunity with dysglycemia and is presymptomatic, and stage 3 as onset of symptomatic disease. Adoption of this staging classification provides a standardized taxonomy for type 1 diabetes and will aid the development of therapies and the design of clinical trials to prevent symptomatic disease, promote precision medicine, and provide a framework for an optimized benefit/risk ratio that will impact regulatory approval, reimbursement, and adoption of interventions in the early stages of type 1 diabetes to prevent symptomatic disease.

Publication types

  • Review

MeSH terms

  • Autoantibodies / immunology
  • Autoimmunity / immunology
  • Diabetes Mellitus, Type 1 / classification
  • Diabetes Mellitus, Type 1 / diagnosis*
  • Diabetes Mellitus, Type 1 / immunology
  • Disease Progression
  • Early Diagnosis
  • Genetic Predisposition to Disease
  • Humans
  • Insulin-Secreting Cells / immunology
  • Prediabetic State / classification
  • Prediabetic State / diagnosis
  • Prediabetic State / immunology
  • Prospective Studies
  • Societies, Medical
  • United States

Substances

  • Autoantibodies