Type 1 diabetes happens when the immune system mistakenly attacks the cells in the pancreas that make insulin. This attack doesn’t happen all at once – it develops slowly, over months or even years.
Before the symptoms of type 1 diabetes appear, there’s a hidden phase when the immune system is already destroying insulin-making beta cells. This is early-stage type 1 diabetes.
It means type 1 diabetes has begun, but blood sugar levels are still in the safe range and insulin treatment isn’t needed yet.
How is early-stage type 1 diabetes found?
Early-stage type 1 diabetes is diagnosed through a blood test that detects type 1 diabetes autoantibodies. Autoantibodies are proteins the immune system uses to attack insulin-making beta cells.
Early-stage type 1 diabetes is when two or more autoantibodies are found.
The three stages of early type 1
Early-stage type 1 diabetes moves through three stages.
- Stage 1: Beta cells are in decline, but many are still alive and the pancreas is making enough insulin to keep blood sugar levels in a safe range.
- Stage 2: More beta cells have been destroyed and blood sugar levels start to rise, but not high enough to cause any symptoms.
- Stage 3: Most beta cells have been destroyed and the pancreas can’t make enough insulin anymore. Blood sugar levels rise into the diabetes range, symptoms appear and insulin treatment is needed. This is usually the point when someone would be diagnosed with type 1 diabetes.
Testing for early-stage type 1 diabetes
Children and adults can get type 1 diabetes screening for autoantibody tests as part of research projects and, in some cases, through the NHS.
Treating early-stage type 1 diabetes
Finding type 1 diabetes early offers the chance to use treatments that slow down its progress. Immunotherapies work by dampening down the immune system’s attack, to protect beta cells before too many have been destroyed.
The world’s first type 1 diabetes immunotherapy – teplizumab – is licensed in the UK for people aged 8 years or over at stage 2 of early type 1 diabetes. It can delay a full diagnosis of type 1 diabetes by around three years. Teplizumab isn’t yet routinely available on the NHS.
