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

RA Insel, JL Dunne, MA Atkinson, JL Chiang… - Diabetes …, 2015 - Am Diabetes Assoc
RA Insel, JL Dunne, MA Atkinson, JL Chiang, D Dabelea, PA Gottlieb, CJ Greenbaum…
Diabetes care, 2015Am Diabetes Assoc
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 …
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.
Am Diabetes Assoc