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
Authors' conclusion
The PLS and a novel non-OGTT-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.
Study context
- Population
- Children aged 1.75–10 years with early-stage (stage 1 or stage 2) T1D identified by islet autoantibody screening of 211,464 children in Germany (Fr1da), staged by oral glucose tolerance test (OGTT) and hemoglobin A1c (HbA1c) (ADA criteria), followed 3–6 months360 stage 1
- Participants
- 485 children
- Exposure
- Progression likelihood score categories for risk of stage 3 T1D
- Outcome
- Progression to clinical stage 3 T1D
- Follow-up
- 2-year risk
Methodological detailspopulation-based screening (Fr1da), multivariable Cox proportional hazards models
- Population-based screening (Fr1da)
- Multivariable Cox proportional hazards models
Main finding
As reported in the abstract
2-year risk of stage 3, stage 1 · 2 years
- Stage 3 developed among stage 1 children (median follow-up 3.3 years)
- 105
Observational data: associations, not effects.
Further findings
Adding obesity to the progression likelihood score (PLS) model
- Adding the variable obesity improved the existing model
2-year risk of stage 3, stage 2 with a single dysglycemic abnormality, stratified by PLS
- PLS stratified 2-year risk from
- 42.4% (95% CI 22.8-57.0) to 5.6% (0.0-15.6)
Non-OGTT-based score (IA-2A titer categories, HbA1c, obesity, IA-2 juxtamembrane epitope autoantibody positivity) · 2 years
- Low 2-year risk
- 1.7%
- Moderate 2-year risk
- 24.6%
Original publication
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. Diabetes Care. Published 16 December 2025. doi:10.
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