Composite Risk Scores as Tools for Improved T1D Risk Prediction

Learning Objectives

• Recognize the limitations of the oral glucose tolerance test (OGTT) in predicting T1D progression 
• Understand the value of incorporating additional risk factors for more robust stratification, especially in children
• Identify the critical need for simplified, real-world implementation of T1D risk prediction tools

Summary

At IDS, Prof. Wentworth discussed how T1D risk prediction can be improved through the development of tools that integrate multiple risk factors and biomarkers.

While the OGTT remains a strong predictor of progression to Stage 3 T1D, it carries significant limitations, particularly in pediatric settings, and must be complemented by additional risk factors such as IA-2A antibody status, age, and increasingly, BMI as a modifiable variable. Several integrated risk scores already exist, including the M120 score, the Progression Likelihood Score (PLS), and the Combined Risk Score (CRS), many of which incorporate the OGTT alongside these factors. Prof. Wentworth urged the field to benchmark any new tools against existing capabilities, noting that current prediction is already reasonably strong. He highlighted a significant implementation gap, suggesting that simpler, OGTT-free approaches like the non-OGTT PLS may prove most practical in real-world settings. Continuous glucose monitoring was highlighted as promising tool that is currently limited by lack of controlled conditions. Prof. Wentworth’s overarching message was clear: the priority is not necessarily building better tools, but properly deploying and testing the ones we already have.

MAT-GLB-2600301 - 1.0 - 06/2026