The Stages of Type 1 Diabetes

Learning Objectives

• Gain a brief overview of the stages in type 1 diabetes progression, from presymptomatic phases to clinical onset
• Explore how detecting islet autoantibodies can predict the risk and progression of autoimmune type 1 diabetes
• Understand how monitoring can reduce complications such as diabetic ketoacidosis, and improve outcomes during disease progression

Summary

The risk of developing clinical type 1 diabetes can be identified months-to-years in advance based on the detection of two or more autoantibodies to beta-cell autoantigens.
Individuals with positive autoantibody status can be categorized into distinct stages based on progressive changes in glycemic status that lead to eventual insulin dependence.​
There is a correlation between the type, number, and titer of autoantibodies detected in screening and the risk of progression to Stage 3 autoimmune T1D.​

The 5-year risk of clinical onset of type 1 diabetes is 44% at Stage 1, and 75% at Stage 2. For Stages 1 and 2, the lifetime risk of developing clinical type 1 diabetes approaches 100%.​ Staging provides a window of opportunity for monitoring, education and preparation.​ Monitoring has been shown to substantially reduce the incidence of DKA, and to significantly reduce the rates and lengths of hospitalization at clinical onset of Stage 3 disease.​

International clinical guidance provides expert advice on monitoring individuals with presymptomatic type 1 diabetes.

MAT-XU-2500235 (v1.0) Date of preparation: 02/2025