{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T17:54:58Z","timestamp":1788285298663,"version":"build-2803163510"},"reference-count":39,"publisher":"Wiley","license":[{"start":{"date-parts":[[2025,5,28]],"date-time":"2025-05-28T00:00:00Z","timestamp":1748390400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000329","name":"Novo Nordisk UK Research Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000329","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Diabet Med"],"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aims<\/jats:title><jats:p>Current guidance on how best to monitor children and young people (CYP) with early\u2010stage type 1 diabetes is evidenced mainly by expert consensus. This systematic review and meta\u2010analysis aims to evaluate the current evidence for tests used to predict disease progression.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Data were sourced from PubMed, Cochrane Central, Ovid Embase and Scopus. The association (hazard ratio [HR]) between test positivity and progression to stage 3 type 1 diabetes in CYP aged \u226418\u2009years with \u22652 islet autoantibodies was examined. Data were pooled using random effects models, and the Hartung\u2013Knapp\u2013Sidik\u2013Jonkman (HKSJ) method was used to adjust confidence intervals to account for greater uncertainty. The risk of bias was evaluated using the QUADAS\u20102 tool (CRD42023393960).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In this study, 12,923 studies were identified and 285 underwent full\u2010text review. Thirty\u2010four studies (<jats:italic>n<\/jats:italic>\u2009=\u20096866 CYP, median age 11.8\u2009years [IQR, 6.6\u201313.8]) were included. Overall, 2080 (30%) CYP progressed to stage 3 type 1 diabetes over a median follow\u2010up of 5\u2009years (IQR 2\u20135). The pooled HR for tests that predicted progression were: 1.40 (95% CI 1.07\u20131.84) for fasting glucose (OGTT), 3.19 (1.75\u20135.82) for 2\u2010h glucose (OGTT), 6.43 (1.21\u201334.18) for the M120 above the median value, 3.12 (2.19\u20134.43) per 1\u2010unit increase in Index 60 and 1.40 (1.17\u20131.68) per 1.1\u2009mmol\/mol increase in HbA1c (C\u2010statistics 0.7\u20130.8). Evidence for other tests, including CGM, was uncertain.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The OGTT, its related tests (M120, Index60) and HbA1c predict progression to stage 3 in CYP with early\u2010stage type 1 diabetes. Other tests, including CGM, need more evidence to support their use as predictive tests in this context.<\/jats:p><\/jats:sec>","DOI":"10.1111\/dme.70077","type":"journal-article","created":{"date-parts":[[2025,5,29]],"date-time":"2025-05-29T05:00:41Z","timestamp":1748494841000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Testing methods used to predict disease progression in children with early\u2010stage type 1 diabetes: A systematic review and meta\u2010analysis"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5815-7279","authenticated-orcid":false,"given":"Rabbi","family":"Swaby","sequence":"first","affiliation":[{"name":"Centre for Human Genetics, Nuffield Department of Medicine, NIHR Oxford Biomedical Research Centre University of Oxford  Oxford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kruthika","family":"Narayan","sequence":"additional","affiliation":[{"name":"Charles Perkins Centre and Faculty of Medicine and Health University of Sydney  Sydney New South Wales Australia"},{"name":"Institute of Endocrinology and Diabetes The Children's Hospital at Westmead  Westmead New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2934-4427","authenticated-orcid":false,"given":"Claire","family":"Scudder","sequence":"additional","affiliation":[{"name":"Centre for Human Genetics, Nuffield Department of Medicine, NIHR Oxford Biomedical Research Centre University of Oxford  Oxford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julia","family":"Townson","sequence":"additional","affiliation":[{"name":"Centre for Trials Research Cardiff University  Cardiff UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3581-8980","authenticated-orcid":false,"given":"Richard A.","family":"Oram","sequence":"additional","affiliation":[{"name":"NIHR Exeter Biomedical Research Centre University of Exeter  Exeter UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5638-4048","authenticated-orcid":false,"given":"Kirstine J.","family":"Bell","sequence":"additional","affiliation":[{"name":"Charles Perkins Centre and Faculty of Medicine and Health University of Sydney  Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria E.","family":"Craig","sequence":"additional","affiliation":[{"name":"Charles Perkins Centre and Faculty of Medicine and Health University of Sydney  Sydney New South Wales Australia"},{"name":"Institute of Endocrinology and Diabetes The Children's Hospital at Westmead  Westmead New South Wales Australia"},{"name":"Paediatrics and Child Health UNSW Medicine  Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Colin","family":"Dayan","sequence":"additional","affiliation":[{"name":"Centre for Human Genetics, Nuffield Department of Medicine, NIHR Oxford Biomedical Research Centre University of Oxford  Oxford UK"},{"name":"Clinical Diabetes and Metabolism Cardiff University, School of Medicine  Cardiff UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul","family":"Aveyard","sequence":"additional","affiliation":[{"name":"Nuffield Department of Primary Care Health Sciences University of Oxford  Oxford UK"},{"name":"Department of Paediatrics John Radcliffe Hospital  Oxford UK"},{"name":"NIHR Oxford Health Biomedical Research Centre Warneford Hospital  Oxford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4645-6324","authenticated-orcid":false,"given":"Rachel E. J.","family":"Besser","sequence":"additional","affiliation":[{"name":"Centre for Human Genetics, Nuffield Department of Medicine, NIHR Oxford Biomedical Research Centre University of Oxford  Oxford UK"},{"name":"Department of Paediatrics John Radcliffe Hospital  Oxford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,5,28]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc15-1419"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2019.21565"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.2337\/diacare.27.6.1399"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00125-023-05953-0"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/pedi.12541"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc24-S002"},{"issue":"8","key":"e_1_2_10_8_1","first-page":"1276","article-title":"Consensus guidance for monitoring individuals with islet autoantibody\u2013positive pre\u2010stage 3 type 1 diabetes","volume":"47","author":"Phillip M","year":"2024","journal-title":"Diabetes Care"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.n71"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/cei.13360"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpeds.2012.09.012"},{"key":"e_1_2_10_12_1","unstructured":"Veritas Health Innovation.Covidence systematic Review Software.2024. 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