{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T11:42:22Z","timestamp":1791978142985,"version":"4.4.0"},"reference-count":32,"publisher":"American Diabetes Association","issue":"2","license":[{"start":{"date-parts":[[2025,12,16]],"date-time":"2025-12-16T00:00:00Z","timestamp":1765843200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.diabetesjournals.org\/journals\/pages\/license"}],"funder":[{"name":"Deutsche Diabetiker Bund e.V. and the Innovative Health Initiative Joint Undertaking","award":["101132379"],"award-info":[{"award-number":["101132379"]}]},{"DOI":"10.13039\/100020098","name":"Innovative Health Initiative","doi-asserted-by":"publisher","award":["101132379"],"award-info":[{"award-number":["101132379"]}],"id":[{"id":"10.13039\/100020098","id-type":"DOI","asserted-by":"publisher"}]},{"name":"LifeScience Stiftung","award":["HMGU 2014.01, HMGU 2016.01"],"award-info":[{"award-number":["HMGU 2014.01, HMGU 2016.01"]}]},{"DOI":"10.13039\/100031584","name":"Deutsches Zentrum for Diabetesforschung","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100031584","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100007028","name":"Leona M. and Harry B. Helmsley Charitable Trust","doi-asserted-by":"publisher","award":["G-1911-3274"],"award-info":[{"award-number":["G-1911-3274"]}],"id":[{"id":"10.13039\/100007028","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Breakthrough T1D","award":["1-SRA-2014-310-M-R, 3-SRA-2019-718-Q-R, 3-SRA-2015"],"award-info":[{"award-number":["1-SRA-2014-310-M-R, 3-SRA-2019-718-Q-R, 3-SRA-2015"]}]}],"content-domain":{"domain":["diabetesjournals.org"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,2,1]]},"abstract":"<jats:sec>\n                    <jats:title>OBJECTIVE<\/jats:title>\n                    <jats:p>To stratify the progression rate to clinical stage 3 type 1 diabetes in children with early-stage disease.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESEARCH DESIGN AND METHODS<\/jats:title>\n                    <jats:p>The Fr1da study tested 211,464 children aged 1.75\u201310 years for islet autoantibodies. Children with early-stage type 1 diabetes were classified as stage 1 or stage 2 by oral glucose tolerance test (OGTT) and hemoglobin A1c (HbA1c) using current American Diabetes Association criteria and were followed 3\u20136 months. We applied our previously developed progression likelihood score (PLS), a composite of HbA1c, 90-min OGTT glucose, and islet antigen 2 antibodies (IA-2A) titer, and developed a non\u2013OGTT-based score using multivariable Cox proportional hazards models to stratify progression rates to stage 3.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>Of 485 children who participated in staging, 360 (74.2%) were diagnosed with stage 1. Of these, stage 3 developed in 105 (median follow-up 3.3 years). PLS stratified the 2-year risk for stage 3 from 43.7% (95% CI 24.3\u201358.1) in children with high PLS to 4.7% (1.7\u20137.7) and 0% in those with intermediate or low PLS. Adding the variable obesity improved the existing model. In children with stage 2 with a single dysglycemic abnormality, PLS could stratify 2-year risk for stage 3 from 42.4% (95% CI 22.8\u201357.0) to 5.6% (0.0\u201315.6). A non\u2013OGTT-based score based on IA-2A titer categories, HbA1c, obesity, and autoantibody positivity for IA-2 juxtamembrane epitopes could identify individuals with low (1.7%) and moderate (24.6%) 2-year risk.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS<\/jats:title>\n                    <jats:p>The PLS and a novel non\u2013OGTT-based score can stratify the short- to medium-term progression rates to stage 3 and should be considered for guiding monitoring practices and clinical trial eligibility.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.2337\/dc25-2184","type":"journal-article","created":{"date-parts":[[2025,12,16]],"date-time":"2025-12-16T21:03:22Z","timestamp":1765919002000},"page":"352-360","update-policy":"https:\/\/doi.org\/10.2337\/ada-journal-policies","source":"Crossref","is-referenced-by-count":6,"title":["Stratifying the Rate of Disease Progression by Progression Likelihood Scores in Children and Adolescents With Stage 1 and Stage 2 Type 1 Diabetes in Germany"],"prefix":"10.2337","volume":"49","author":[{"given":"Andreas","family":"Weiss","sequence":"first","affiliation":[{"name":"Institute of Diabetes Research, Helmholtz Munich, German Research Center for Environmental Health 1 , Munich, Germany"},{"name":"German Center for Diabetes Research (DZD) 2 , Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lenche","family":"Chakievska","sequence":"additional","affiliation":[{"name":"Institute of Diabetes Research, Helmholtz Munich, German Research Center for Environmental Health 1 , Munich, Germany"},{"name":"German Center for Diabetes Research (DZD) 2 , Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6720-2684","authenticated-orcid":false,"given":"Peter","family":"Achenbach","sequence":"additional","affiliation":[{"name":"Institute of Diabetes Research, Helmholtz Munich, German Research Center for Environmental Health 1 , Munich, Germany"},{"name":"German Center for Diabetes Research (DZD) 2 , Munich, Germany"},{"name":"Forschergruppe Diabetes at Klinikum rechts der Isar, School of Medicine and Health, Technical University Munich 3 , Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maja","family":"Hergl","sequence":"additional","affiliation":[{"name":"Institute of Diabetes Research, Helmholtz Munich, German Research Center for Environmental Health 1 , Munich, Germany"},{"name":"German Center for Diabetes Research (DZD) 2 , Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6554-5974","authenticated-orcid":false,"given":"Sandra","family":"Hummel","sequence":"additional","affiliation":[{"name":"Institute of Diabetes Research, Helmholtz Munich, German Research Center for Environmental Health 1 , Munich, Germany"},{"name":"German Center for Diabetes Research (DZD) 2 , Munich, Germany"},{"name":"Forschergruppe Diabetes at Klinikum rechts der Isar, School of Medicine and Health, Technical University Munich 3 , Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raffael","family":"Ott","sequence":"additional","affiliation":[{"name":"Institute of Diabetes Research, Helmholtz Munich, German Research Center for Environmental Health 1 , Munich, Germany"},{"name":"German Center for Diabetes Research (DZD) 2 , Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marlon","family":"Scholz","sequence":"additional","affiliation":[{"name":"Institute of Diabetes Research, Helmholtz Munich, German Research Center for Environmental Health 1 , Munich, Germany"},{"name":"German Center for Diabetes Research (DZD) 2 , Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christiane","family":"Winkler","sequence":"additional","affiliation":[{"name":"Institute of Diabetes Research, Helmholtz Munich, German Research Center for Environmental Health 1 , Munich, Germany"},{"name":"German Center for Diabetes Research (DZD) 2 , Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8704-4713","authenticated-orcid":false,"given":"Ezio","family":"Bonifacio","sequence":"additional","affiliation":[{"name":"German Center for Diabetes Research (DZD) 2 , Munich, Germany"},{"name":"Center for Regenerative Therapies Dresden, Faculty of Medicine, Technische Universit\u00e4t Dresden 4 , Dresden, Germany"},{"name":"Paul Langerhans Institute Dresden of the Helmholtz Munich at University Hospital Carl Gustav Carus and Faculty of Medicine, Technische Universit\u00e4t Dresden 5 , Dresden, 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