Type 1 Diabetes Stages
Stages |
|---|
1 positive islet autoantibody*, normal glucose levels (formerly Stage 0) |
Stage 1: ≥ 2 islet autoantibodies*, presymptomatic, normal FPG levels (< 100 mg/dL [< 5.6 mmol/L]) and glucose tolerance (2-hour PG < 140 mg/dL [< 7.8 mmol/L]) |
Stage 2: ≥ 2 islet autoantibodies, usually presymptomatic, not meeting American Diabetes Association diagnostic criteria but with elevated FPG, HbA1C 5.7–6.4% (39–48 mmol/mol), or ≥ 10% change in HbA1C, or impaired glucose tolerance (2-hour PG 140–199 mg/dL [7.8–11.1 mmol/L] or 30-, 60-, or 90-minute PG > 200 mg/dL [11.1 mmol/L]) Stage 2a: FPG 100–115 mg/dL (5.6–6.4 mmol/L) Stage 2b: FPG 116–125 mg/dL (6.5-6.9 mmol/L) |
Stage 3 (clinical type 1 diabetes): Elevated glucose or abnormal glucose tolerance meeting American Diabetes Association criteria, ≥ 2 islet autoantibodies:
Stage 3a: Asymptomatic (requires confirmatory diagnostic testing) Stage 3b: Symptomatic |
Stage 4: Long-term type 1 diabetes |
* Measured in ≥ 2 samples. |
† An oral glucose tolerance test is not required and should not be performed if diabetes can be diagnosed by other criteria. When needed, the test should be done using 1.75 g/kg (maximum 75 g) glucose dissolved in water; a positive result is a 2-hour plasma glucose level ≥ 200 mg/dL (11.1 mmol/L). |
FPG = fasting plasma glucose; HbA1C = glycosylated hemoglobin; OGTT = oral glucose tolerence test; PG = postprandial glucose. |
Data from Haller MJ, Bell KJ, Besser REJ, et al. ISPAD Clinical Practice Consensus Guidelines 2024: Screening, Staging, and Strategies to Preserve Beta-Cell Function in Children and Adolescents with Type 1 Diabetes. Horm Res Paediatr. 2024;97(6):529-545. doi:10.1159/000543035 |