JDRF and the American Diabetes Association announce new staging for Type 1 Diabetes

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The news was announced today about a new classification approach for the development of type 1 diabetes (T1D). Three distinct stages will mark the development of the disease – from its earliest pre symptomatic stages to full blown onset. The aim of staging is to help preserve more insulin-producing beta cell function and make further strides toward prevention.

JDRF and the American Diabetes Association, with several leading diabetes research and clinical organizations, collaborated on the development of the staging approach. The American Association of Clinical Endocrinologists, the International Society for Pediatric and Adolescent Diabetes and The Leona M. and Harry B. Charitable Trust have already endorsed it.

“We know type 1 diabetes begins long before insulin dependence occurs, and the best time to halt the disease’s progress is before the loss of insulin-producing pancreatic beta cells,” said JDRF’s Chief Scientific Officer, Richard Insel, M.D. “Decades of research in at-risk individuals have provided the foundation for developing this new three-stage diagnostic approach, which we believe will help optimize the design of clinical trials to prevent symptomatic disease and more quickly evaluate interventions.”

Desmond Schatz, M.D., president-elect, medicine and science at American Diabetes Association explained, “Type 1 diabetes is diagnosed relatively late in the disease process.” Now pre-type 1 diabetes can be identified both in higher risk relatives and the lower risk general population by using a combination of genetic, immunologic and metabolic markers and categorization of the natural history of the early disease process which is now possible.” According to Schatz this will facilitate prevention studies at different stages of the disease process.

Personally, I always keep hearing as well that figuring out how to prevent type 1 diabetes may be necessary before we find a cure.

Regarding staging, two years ago I wrote on The Huffington Post that we should characterize type 2 diabetes in stages – “The Lie That’s Killing Us: Pre-Diabetes.” Diagnosing people with “pre-diabetes” doesn’t inspire the action that calling it stage 1 of type 2 diabetes likely would. Many of the current 80 million people with “pre-diabetes” will go on to get type 2 diabetes. Yet, if they heard that they had stage 1 type 2 diabetes they might well make the lifestyle changes – eating a healthier diet, losing weight, being active and possibly medication – that might prevent it. I’m still in favor of this.

For myself as a type 1, I remember how surprised I was years ago when endocrinologist Gerald Bernstein, who ran the Friedman Diabetes Center in Manhattan, told me that while I got type 1 diabetes at age eighteen, I probably began developing it when I was twelve. And I have a theory why that might be so.

We talk about type 1 diabetes coming on like a bullet train but apparently there’s a slow escalation and now researchers are able to see distinct metabolic markers of the disease’s progression. Marking the stages of the disease will help facilitate prevention studies, and hopefully one day, prevention – and a cure.

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Comments (5)

  1. Joanne hallswort at

    I have three children two of them the eldest who is now 14 and the youngest who is just 8. Have both got type one diabetes .
    The eldest was diagnosed first 10 3/4 she was very poorly as we could not read the early signs. My son has just been diagnosed in July at 8 , I just did a ketones test as he wet the bed a couple of times after been dry since he was two. He was very well apart from that but when we got in hospital he had a blood sugar of 33.
    He went straight onto insulin what has gone very quickly into the honeymoon period needing just tiny amounts of insulin.
    I have been offered a trial net for my middle daughter and I am wondering whether to do it or not could you give me some advice.
    Is there any benefit in knowing or just knowing the inevitable?

  2. Riva Greenberg
    riva at

    I don’t know Joanne whether there’s benefit, except they are working to try and prevent T1D so if your middle child is identified as a candidate there might be something they can do now

  3. Sheryl at

    What you can do now… Get, read and apply Dr. Richard Bernstein’s book, Diabetes Solution, to your family’s life. http://www.diabetes-book.com or buy it on Amazon.com

  4. Gail at

    Yes, there is benefit. Your daughter could have been identified as a candidate for a prevention trial. While they are not cures, the prevention trials may delay the onset of T1D. Participating in the prevention trials also helps us learn which drugs to keep pursuing, and in what combinations.

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***The opinions and views expressed in this blog belong to the individual contributor and not to ASweetLife or its editors. All information contained on this blog is intended for informational purposes only. The information is not intended to be a replacement or substitute for consultation with a qualified medical professional or for professional medical advice related to diabetes or another medical condition. Please contact your physician or medical professional with any questions and concerns about your medical condition.