Benefits of preserving beta cells in stages 2 and early 3

Abstract

Type 1 diabetes (T1D) is a progressive disease that begins long before symptoms appear. It starts with autoimmunity against pancreatic beta cells, progresses to abnormalities in blood glucose levels, and eventually manifests as clinical diabetes.

In stage 2, the presence of multiple autoantibodies and dysglycemia indicates a high risk of progression to stage 3. However, the individual remains asymptomatic and retains some capacity to produce insulin. Preserving this function may delay the onset of clinical diabetes and prolong the time without insulin therapy. For children and their families, this means maintaining their usual daily lives for longer without the demands of daily diabetes management, while allowing time for preparation, education, and support. In addition, scheduled follow-up enables early recognition of clinical onset and reduces the risk of a severe presentation.

In early stage 3, preserving residual insulin production also provides clinical benefits. It may facilitate glycemic management, reduce insulin requirements, and lower the risk of hypoglycemia. It may also promote greater metabolic stability and potentially help reduce the risk of long-term complications.

Therefore, preserving beta-cell function does not merely mean delaying disease progression. It may also make the transition to treatment more gradual and manageable, reduce the daily burden of diabetes, and improve metabolic control from the earliest stages. These benefits support screening, monitoring, and early intervention as strategies to modify the natural course of T1D.