T1D develops in stages, and there is opportunity to diagnose early and address it

Most people think of T1D in the final chronic stage, where patients are hyperglycemic and insulin dependent. But prior to this, there is a period in which the disease is present and detectable, but typically develops undiagnosed.1

T1D Illustration
  • T1D develops in stages, with ≥2 detectable autoantibodies marking the onset of the disease1
  • T1D will inevitably progress from subclinical stages to diagnosed disease1
  • In stage 1, ≥2 autoantibodies are present, but patients are normoglycemic1
  • In stage 2, ≥2 autoantibodies remain present and patients begin to be dysglycemic, though they remain subclinical, typically1
  • Diagnosis typically occurs in stage 3, when patients are hyperglycemic and symptomatic1

Autoantibodies are present in the early stages of disease. So, T1D can be detected before patients become insulin dependent1:

Blood test

A blood test can detect autoantibodies and diagnose T1D before clinical disease arises.1

Autoantibodies

Once a patient develops 2 or more autoantibodies, their lifetime risk of clinical T1D approaches 100%.1

Subclinical patients entering stage 3 of T1D have already lost a significant portion of their β cells1

Tests are available (easily accessible by major labs) for 4 types of islet-cell autoantibodies2:
  • Autoantibodies to insulin
  • Autoantibodies to GAD (GAD65)
  • Autoantibodies to the tyrosine phosphatases IA-2 and IA-2b
  • Autoantibodies to Zn Transporter 8

Inevitable progression1,3

T1D Illustration
Lifetime risk of clinical T1D approaches 100% for patients with ≥2 autoantibodies1,3
T1D Illustration

Current therapies still result in poor glucose control and suboptimal health outcomes

Even with advanced tools such as continuous glucose monitoring, many T1D patients are poorly controlled5

T1D Illustration

Adherence to insulin therapy remains a challenge, especially for young patients, and studies have shown a significant drop in glycemic control as young patients transition to adolescence.10


There is substantial opportunity to improve upon the standard of care, which leaves many patients’ diabetes uncontrolled.

1. Insel RA, Dunne JL, Atkinson MA, et al. Staging presymptomatic type 1 diabetes: a scientific statement of JDRF, the Endocrine Society, and the American Diabetes Association. Diabetes Care. 2015;38(10):1964-1974. 2. LabCorp. Diabetes autoimmune profile. https://www.labcorp.com/tests/504050/diabetes-autoimmune-profile. Accessed August 17, 2020. 3. Ziegler AG, Rewers M, Simell O, et al. Seroconversion to multiple islet autoantibodies and risk of progression to diabetes in children. JAMA. 2013;309(23):2473-2479. 4. Writing Committee for Type 1 Diabetes TrialNet Oral Insulin Study Group; Krischer JP, Schatz DA, Bundy B, Skyler JS, Greenbaum CJ. Effect of oral insulin on prevention of diabetes in relatives of patients with type 1 diabetes: a randomized clinical trial. JAMA. 2017;318(19):1891-1902. 5. Foster NC, Beck RW, Miller KM, et al. State of type 1 diabetes management and outcomes from the T1D Exchange in 2016-2018. Diabetes Technol Ther. 2019;21(2):66-72. 6. Quianzon CC, Cheikh I. History of insulin. J Community Hosp Intern Med Perspect. 2012;2(2). 7. Atkinson MA, Eisenbarth GS, Michels AW. Type 1 diabetes. Lancet. 2014;383(9911):69-82. 8. American Diabetes Association. Understanding A1C. https://www.diabetes.org/a1c. Accessed August 31, 2020. 9. DiMeglio LA, Acerini CL, Codner E, et al. ISPAD clinical practice consensus guidelines 2018: glycemic control targets and glucose monitoring for children, adolescents, and young adults with diabetes. Pediatr Diabetes. 2018;19(suppl 27):105-114. 10. Datye KA, Moore DJ, Russell WE, Jaser SS. A review of adolescent adherence in type 1 diabetes and the untapped potential of diabetes providers to improve outcomes. Curr Diab Rep. 2015;15(8):51.