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

    Diabetes care, 10/2015, Letnik: 38, Številka: 10
    Journal Article

    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.