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

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

Author information

1
JDRF, New York, NY rinsel@jdrf.org.
2
JDRF, New York, NY.
3
UF Diabetes Institute, University of Florida, Gainesville, FL.
4
American Diabetes Association, Alexandria, VA.
5
Colorado School of Public Health, University of Colorado, Denver, CO.
6
Barbara Davis Center for Childhood Diabetes, University of Colorado, Aurora, CO.
7
Benaroya Research Institute at Virginia Mason, Seattle, WA.
8
Department of Immunobiology, Yale School of Medicine, New Haven, CT.
9
Department of Pediatrics, Pediatric Epidemiology Center, Morsani College of Medicine, University of South Florida, Tampa, FL.
10
Lund University/Clinical Research Centre, Skåne University Hospital, Malmö, Sweden.
11
Diabetes Research Institute, University of Miami, Miami, FL.
12
Institute of Diabetes Research, Helmholtz Zentrum München, Munich and Forschergruppe Diabetes, Klinikum rechts der Isar, Technische Universität München, Neuherberg, Germany.

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.

PMID:
26404926
PMCID:
PMC5321245
DOI:
10.2337/dc15-1419
[Indexed for MEDLINE]
Free PMC Article

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