Since T1D is increasingly recognized as a heterogeneous disorder, we sought to determine whether different diagnostic criteria could identify individuals with a distinct profile of markers typical for T1D.

We studied autoantibody positive (Ab+) TrialNet Pathway to Prevention participants. Markers that typically cluster in individuals diagnosed with T1D were compared between groups defined by oral glucose tolerance test (OGTT) 2-hour glucose ≥200 mg/dl (2hrglu≥200), which is an ADA standard diagnostic criterion, and Index60≥2.00 (Ind60≥2.00; based on fasting C-peptide [C-pep] and OGTT 60-minute C-pep and 60-minute glucose), which has previously shown potential utility as a diagnostic criterion for T1D. Three groups were compared: (A) 2hrglu≥200 Only (Ind60 <2.00), (B) Ind60≥2.00 Only (2hrglu <200), and (C) Both Ind60≥200 and 2hrglu≥2.00.

Participants in the Ind60≥2.00-Only or Ind60≥2.00 and 2hrglu≥200 groups were younger, had lower 30-0 minute C-pep and AUC C-pep, and had higher percentages of mIAA and multiple Ab+ compared with those in the 2-hrglu≥200 Only group (Table).

In sum, individuals with Ind60≥2.00 had more characteristic T1D features than those with 2-hrglu≥200 but Ind60 <2.00, who were atypical. It thus appears that the use of T1D-specific diagnostic measures, such as Ind60≥2.00, may help identify more homogeneous groups of individuals with T1D.

M.J. Redondo: None. B.M. Nathan: None. L.E. Bocchino: None. S. Geyer: None. L.M. Jacobsen: None. E.K. Sims: None. A. Pugliese: None. J.S. Skyler: Advisory Panel; Self; ADOCIA, Applied Therapeutics, Dance Biopharm Holdings Inc., Orgenesis Ltd., Tolerion, Inc., Viacyte, Inc. Board Member; Self; Dexcom, Inc., Intarcia Therapeutics, Inc., Moerae Matrix, Inc. Consultant; Self; AstraZeneca, Boehringer Ingelheim Pharmaceuticals, Inc., Dalcor, Dialogics, Elcelyx Therapeutics, Inc., Esperion, GeNeuro Innovation, Ideal Life, Immunomolecular Therapeutics, Intrexon, Kamada, Nestlé, Sanofi, Valeritas, Inc., Zafgen, Inc. Stock/Shareholder; Self; Dexcom, Inc., Ideal Life, Intarcia Therapeutics, Inc., Intrexon, Moerae Matrix, Inc. J.P. Palmer: None. J. Sosenko: None.


National Institutes of Health

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