Staging Presymptomatic Type 1 Diabetes: A Scientific Statement of JDRF, the Endocrine Society, and the American Diabetes Association

被引：712

作者：

Insel, Richard A. ^{[1
]}

Dunne, Jessica L. ^{[1
]}

Atkinson, Mark A. ^{[2
]}

Chiang, Jane L. ^{[3
]}

Dabelea, Dana ^{[4
]}

Gottlieb, Peter A. ^{[5
]}

Greenbaum, Carla J. ^{[6
]}

Herold, Kevan C. ^{[7
]}

Krischer, Jeffrey P. ^{[8
]}

Lernmark, Ake ^{[9
]}

Ratner, Robert E. ^{[3
]}

Rewers, Marian J. ^{[5
]}

Schatz, Desmond A. ^{[2
]}

Skyler, Jay S. ^{[10
]}

Sosenko, Jay M. ^{[10
]}

Ziegler, Anette-G. ^{[11
,12
]}

机构：

[1] JDRF, New York, NY 10016 USA

[2] Univ Florida, UF Diabet Inst, Gainesville, FL USA

[3] Amer Diabet Assoc, Alexandria, VA USA

[4] Univ Colorado, Colorado Sch Publ Hlth, Denver, CO 80202 USA

[5] Univ Colorado, Barbara Davis Ctr Childhood Diabet, Aurora, CO USA

[6] Benaroya Res Inst Virginia Mason, Seattle, WA USA

[7] Yale Univ, Sch Med, Dept Immunobiol, New Haven, CT USA

[8] Univ S Florida, Dept Pediat, Pediat Epidemiol Ctr, Morsani Coll Med, Tampa, FL 33620 USA

[9] Lund Univ, Skane Univ Hosp, Clin Res Ctr, Malmo, Sweden

[10] Univ Miami, Diabet Res Inst, Miami, FL USA

[11] Helmholtz Zentrum Munchen, Diabet Res Inst, Munich, Germany

[12] Tech Univ Munich, Klinikum Rechts Isar, Forschergrp Diabet, Neuherberg, Germany

来源：

DIABETES CARE | 2015年 / 38卷 / 10期

基金：

美国国家卫生研究院;

关键词：

BETA-CELL DEATH; MULTIPLE ISLET AUTOANTIBODIES; TRANSPORTER; 8; AUTOANTIBODIES; GLUCOSE-TOLERANCE; ENVIRONMENTAL DETERMINANTS; SUSCEPTIBILITY GENES; INSULIN-RESISTANCE; HIGH-RISK; METABOLIC PROGRESSION; 1ST-DEGREE RELATIVES;

D O I：

10.2337/dc15-1419

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

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 -cell autoimmunity as evidenced by the presence of two or more islet autoantibodies with normoglycemia and is presymptomatic, stage 2 as the presence of -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.

引用

页码：1964 / 1974

页数：11

共 131 条

[11] Clinical characteristics of children diagnosed with type 1 diabetes through intensive screening and follow-up [J].