TrialNet, a worldwide leader in type 1 diabetes research, developed a new type 1 diabetes staging classification that identifies the disease’s progression. According to researchers, the classification system may help with earlier diagnosis, delaying disease progression and possibly preventing the disease.
The system is recommended by the JDRF, Diabetes Care, Endocrine Society, and the American Diabetes Association (ADA). It is based on about two decades of TrialNet research comprising more than 150,000 relatives of individuals with type 1 diabetes. The program also offers screening and clinical trials for every stage of the disease, in addition to close monitoring.
TrialNet’s Stage One, the start of type 1 diabetes, begins when individuals test positive for two or more autoantibodies known to be related to diabetes. At this stage, the immune system has already begun attacking the insulin-producing pancreatic beta cells even though there is an absence of symptoms, and blood sugar levels remain normal.
Stage Two is similar to Stage One, but now blood sugar levels test abnormal due to an increase in the loss of beta cells. Patients still remain symptom-free, however. A lifetime risk of developing type 1 diabetes is close to 100 percent for both Stage One and Stage Two.
At Stage Three, there is usually a clinical diagnosis of type 1 diabetes, with a significant loss of pancreatic beta cells and typical symptoms such as excessive thirst, frequent urination, fatigue, and weight loss.
Researchers believe that early diagnosis, before the onset of Stage Three, can be useful for earlier intervention and timely preservation of remaining beta cells, which in turn results in a reduction in life-long diabetes-related complications.
“The identification of the pre-symptom stages of type 1 diabetes can be compared to identification of high blood pressure as a predictor of heart attack and stroke,” TrialNet Chair Carla Greenbaum said in a news release.
“Before treatment for high blood pressure became commonplace, we were missing a key tool to prevent heart disease. Today, people can receive intervention long before they experience symptoms or significant complications. The same is now true for Type 1 diabetes,” Greenbaum said.
For people who participate in type 1 diabetes prevention studies like TrialNet, the risk of potentially fatal diabetic ketoacidosis at the time of diagnosis goes from 30 percent to less than 4 percent. The screening test is especially important for people who have relatives with the disease because their risk is 15 times greater than those with no family history of type 1 diabetes.
