The Early-Stage Type 1 Diabetes Clinic helps families monitor their child’s type 1 diabetes progression and prepare them and the family to understand the child’s needs now and in the future.
About Early-Stage Type 1 Diabetes
Early-stage type 1 diabetes refers to the beginning stages of type 1 diabetes, before symptoms appear. Type 1 diabetes is an autoimmune disorder in which the body sends antibodies to attack its own insulin-producing “beta cells.” Insulin is a hormone that aids glucose (sugar) from the blood into different organs (mainly muscles and fats) to use for energy. During the early stages of type 1 diabetes, clinicians identify two or more antibodies that result in the decrease of beta cells.
Stages of Type 1 Diabetes
Stage 1
- Antibodies: Two or more present
- Symptoms: None
- Blood sugar status: Normal (normoglycemia)
- Fasting blood sugar: 70 to 99 mg/dL
- Two hours after meals: Less than 140 mg/dL
- HgbA1c: Less than 5.7%
Stage 2
- Antibodies: Two or more present
- Symptoms: None
- Blood sugar status: Impaired (dysglycemia)
- Fasting blood sugar: 100 to 125 mg/dL
- Two hours after meals: 140 to 199 mg/dL
- HgbA1c: 5.7% to 6.4%
Stage 3
- Antibodies: Two or more present
- Symptoms: May include fatigue, excessive thirst, increased urination, and weight loss
- Blood sugar status: High (hyperglycemia)
- Fasting blood sugar: 126 mg/dL or higher
- Two hours after meals: 200 mg/dL or higher
- HgbA1c: 6.5% or higher
Benefits of Early Detection and Clinic Participation
There are numerous advantages to having your child diagnosed and monitored in the early stages of type 1 diabetes.
Avoiding Diabetic Ketoacidosis (DKA): DKA is an emergent situation that can be life-threatening due to a lack of insulin in the body, leading to the body breaking down fat for energy. Patients tend to get extremely sick, requiring hospitalization. Through clinic participation and monitoring, many patients can avoid DKA.
Access to Clinical Trials and Early Intervention Treatments: Most clinical trials for patients in the early stages of diagnosis of type 1 diabetes are focused on preserving beta cells. There are also FDA-approved treatments, such as Teplizumab, that help preserve beta cells in stage 2 patients.
Preparation: Parents and patients in the Early-Stage Type 1 Diabetes Clinic have the opportunity to meet regularly with the team, including psychologists and dietitians, to help them be prepared for the future when the child needs insulin.
Support and Monitoring: Patients and families attending clinic receive optimal guidance and monitoring.
A Team Approach to Care
During clinic visits, you will have the opportunity to meet with a multidisciplinary team including nutritional support from a registered dietician as well as psychological support from the psychology team. The endocrinologist will see you during each visit to assess rate of progression throughout the various stages of T1D.
Frequently Asked Questions
Is there a way to reverse positive antibodies? Is there a cure for type 1 Diabetes?
Researchers continue working hard towards a cure for T1D. While there is currently no cure, there are some treatments and clinical trials that may preserve cell function and delay progression to stage 3. It is important to note that T1D is not caused by lifestyle or your child eating too much sugar.
Should I change what my child eats?
A healthy diet is always encouraged, including decreasing simple carbohydrates such as juice, sodas and sweets. A healthy weight and diet lower the stress on insulin-producing cells, preserving their lifespan.
I have other kids, are they at risk?
Yes, there is an increased risk for first- and second-degree relatives. Screening for antibodies is recommended for first-degree relatives (siblings, mother, father) ages 2 to 45 years and second-degree relatives (cousins, aunts, uncles, nieces, nephews, half-siblings). Please contact the office at
786-624-2888 to schedule screening for first-degree relatives.
When will my child require insulin and what will this involve?
At this time, your child does not need insulin, and it is not possible to determine when your child will require insulin as each child progresses through the stages at their own rate. However, stage 3 is typically when insulin is needed to manage the child’s condition. While your child is in the early stages, the clinical care team will familiarize you with the forms of insulin and how they are used so that you will be better prepared when your child needs this treatment.
What do I need to do during early stages?
In stage 1, there is no need to check blood sugar regularly. However, the clinic team will show you how to use a glucometer to check blood sugar levels if symptoms appear or if the child is sick. As the patient progresses through the stages, the staff may ask you to check blood sugar in the morning or after meals or potentially use a continuous glucose monitor.
You should be aware of the signs or symptoms of stage 3 diabetes (unexplained weight loss, drinking water excessively, urinating excessively, very tired and weak). If your child has these symptoms, please contact the office immediately at 786-624-2888.
What treatments are available during these early stages?
Teplizumab is an FDA-approved disease-modifying therapy for patients in Stage 2 or Stage 3 T1D designed to alter the course of the autoimmune attack by slowing down the destruction of insulin-producing beta cells. Aside from this approved treatment, there are other clinical trials available depending on various eligibility requirements.