Staging presymptomatic type 1 diabetes: A scientific statement of jdrf, the endocrine society, and the American diabetes association

Richard A. Insel, Jessica L. Dunne, Mark A. Atkinson, Jane L. Chiang, Dana Dabelea, Peter A. Gottlieb, Carla J. Greenbaum, Kevan C. Herold, Jeffrey P. Krischer, Ake Lernmark, Robert E. Ratner, Marian J. Rewers, Desmond A. Schatz, Jay S. Skyler, Jay M. Sosenko, Anette G. Ziegler

Research output: Contribution to journalArticle

254 Scopus citations

Abstract

Insights fromprospective, 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 b-cell autoimmunity as evidenced by the presence of two or more islet autoantibodies with normoglycemia and is presymptomatic, stage 2 as the presence of b-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.

Original languageEnglish (US)
Pages (from-to)1964-1974
Number of pages11
JournalDiabetes care
Volume38
Issue number10
DOIs
StatePublished - Oct 2015

ASJC Scopus subject areas

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism
  • Advanced and Specialized Nursing

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    Insel, R. A., Dunne, J. L., Atkinson, M. A., Chiang, J. L., Dabelea, D., Gottlieb, P. A., Greenbaum, C. J., Herold, K. C., Krischer, J. P., Lernmark, A., Ratner, R. E., Rewers, M. J., Schatz, D. A., Skyler, J. S., Sosenko, J. M., & Ziegler, A. G. (2015). Staging presymptomatic type 1 diabetes: A scientific statement of jdrf, the endocrine society, and the American diabetes association. Diabetes care, 38(10), 1964-1974. https://doi.org/10.2337/dc15-1419