While the majority of individuals with ≥2 autoantibodies (AAB) will progress to clinical T1D, there are reports that AAB disappear in some individuals. Clinical trials to delay or prevent disease progression often enroll those at stage 1 or 2, defined as individuals with ≥2 AAB confirmed on two separate occasions. Using data from TrialNet’s Pathway to Prevention study, we aimed to determine (a) how many individuals at stage 1 or 2 subsequently lost AAB, and (b) how this impacted the risk of T1D progression.

Individuals confirmed to be at stage 1 or stage 2 diabetes with a mean follow-up of 2.2 years (0.1 to 13) were included (n=3267). 3141 (96%) maintained their status over time while 126 (4%) did not (non-maintainers). This affected their risk of progression (Figure).

Conclusion: Reverting from stage 1 or stage 2 diabetes is rare; yet, if it occurs, the risk of progressing to stage 3 during the follow-up period is reduced. This suggests that there are unknown mechanisms that can lead to immune remission in some individuals.

C. O'Rourke: None. M. So: None. C. Greenbaum: Research Support; Self; Janssen Research & Development. H.T. Bahnson: None. C. Speake: None.


JDRF; National Institutes of Health

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