The Development and Utility of a Novel Scale That Quantifies the Glycemic Progression Toward Type 1 Diabetes Over 6 Months

Abstract

OBJECTIVE We developed a scale to serve as a potential end point for 6-month glycemic progression (PS6M) toward type 1 diabetes (T1D) in autoantibody-positive relatives of individuals with T1D. RESEARCH DESIGN AND METHODS The PS6M was developed from Diabetes Prevention Trial–Type 1 (DPT-1) data and tested in the TrialNet Pathway to Prevention Study (PTP). It is the difference between 6-month glucose sum values (30–120 min oral glucose tolerance test values) and values predicted for nonprogressors. RESULTS The PS6M predicted T1D in the PTP (P < 0.001). The area under the receiver operating chacteristic curve was greater (P < 0.001) for the PS6M than for the baseline–to–6-month difference. PS6M values were higher in those with two or more autoantibodies, 30–0 min C-peptide values <2.00 ng/mL, or DPT-1 Risk Scores >7.00 (P < 0.001 for all). CONCLUSIONS The PS6M is an indicator of short-term glycemic progression to T1D that could be a useful tool for assessing preventive treatments and biomarkers.