Testing methods used to predict disease progression in children with early‐stage type 1 diabetes: A systematic review and meta‐analysis
Authors' conclusion
The OGTT, its related tests (M120, Index60) and HbA1c predict progression to stage 3 in CYP with early-stage type 1 diabetes. Other tests, including CGM, need more evidence to support their use as predictive tests in this context.
Study context
- Population
- Children and young people aged ≤18 years with early-stage T1D (≥2 islet autoantibodies); median age 11.8 years (IQR 6.6–13.8)
- Participants
- 6,866 children34 studies
- Comparison
- Test positivity vs negativity for predicting progression to stage 3 T1D
- Outcome
- Progression to stage 3 T1D (HR for test positivity)
- Follow-up
- Median 5 years (IQR 2-5)
Methodological detailsrandom-effects models, Hartung-Knapp-Sidik-Jonkman (HKSJ)-adjusted CIs, QUADAS-2 risk of bias, 12,923 studies identified; 285 full-text reviewed
- Random-effects models
- HKSJ-adjusted CIs
- QUADAS-2 risk of bias
- 12,923 studies identified; 285 full-text reviewed
Pooled result
As reported in the abstract
Pooled HR for progression to stage 3 T1D, by test
- Fasting glucose (OGTT): pooled HR
- 1.40 (1.07-1.84) (95% CI)
- 2-h glucose (OGTT): pooled HR
- 3.19 (1.75-5.82) (95% CI)
- M120 above median: pooled HR
- 6.43 (1.21-34.18) (95% CI)
- Index 60, per 1-unit increase: pooled HR
- 3.12 (2.19-4.43) (95% CI)
- HbA1c, per 1.1 mmol/mol increase: pooled HR
- 1.40 (1.17-1.68) (95% CI)
- C-statistics
- 0.7-0.8
Further pooled results
Progression to stage 3 T1D · median follow-up 5 years (IQR 2-5)
- Progressed to stage 3 T1D
- 2080 (30%)
Original publication
Testing methods used to predict disease progression in children with early‐stage type 1 diabetes: A systematic review and meta‐analysis. Diabet Med. Published 28 May 2025. doi:10.
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