Stages of T1D

The progression of type 1 diabetes

Type 1 diabetes can now be most accurately understood as a disease that progresses in three distinct stages.

TrialNet screening looks for five diabetes-related autoantibodies that signal an increased risk of T1D. The JDRF, ADA and Endocrine Society now classify having two or more of these autoantibodies as early stage T1D. Finding T1D in its earliest stage allows for prompt intervention aiming to change the course of the disease.

T1D starts with a genetic predisposition—gene(s) that put you at higher risk. Risk for people in the general population is about 1 in 300. If you have a family member with T1D, your risk is 1 in 20.

There are three distinct stages of T1D. The first two stages can be identified by TrialNet screening prior to symptoms. Our goal is to identify the disease in its earliest stage and stop disease progression by preserving beta cell production.

Stages of T1D

Stages of Type 1 Diabetes

Stage 1

Type 1 Diabetes - Stage 1

Stage 1: Normal Blood Sugar

Stage 1 is now considered the start of T1D. Individuals test positive for two or more diabetes-related autoantibodies identified by TrialNet screening. The immune system has started attacking insulin-producing beta cells, although blood sugar levels remain normal and no symptoms are present. Learn more

  • Two or more diabetes-related autoantibodies
  • Normal blood sugar levels
  • No symptoms

Did you know? Research shows that age plays a significant role in the rate of T1D progression. The younger the person, the faster the disease will progress.

Stage 2

Type 1 Diabetes - Stage 2

Stage 2: Abnormal Blood Sugar

Stage 2, like stage 1, includes individuals with two or more diabetes-related autoantibodies, but now blood sugar levels have become abnormal due to increasing loss of beta cells. There are still no symptoms. Learn more

  • Two or more diabetes-related autoantibodies
  • Abnormal blood sugar levels
  • No symptoms

Did you know? For both stage 1 and 2, the lifetime risk of clinical diagnosis (stage 3) nears 100%.

Stage 3

Type 1 Diabetes - Stage 3

Stage 3: Clinical Diagnosis

Stage 3 is when clinical diagnosis typically takes place. By this time, there is significant beta cell loss and symptoms of type 1 diabetes are usually present. Learn more

Clinical T1D diagnosis Significant beta cell loss Symptoms of T1D