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
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
收藏
页码:1964 / 1974
页数:11
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