β-Cell Dysfunction Enhances Prediction of Type 1 Diabetes Progression in Individuals with Single Autoantibody Positivity

Highlight

• Single autoantibody positivity in relatives of type 1 diabetes patients shows variable risk for disease progression.
• Combined metabolic measures of β-cell function, particularly from oral glucose tolerance test-stimulated glucose and C-peptide, robustly identify individuals at high risk for progression.
• Traditional isolated glucose or C-peptide measures and insulin resistance indices vary in predictive value by age and autoantibody type.
• Personalized risk stratification based on metabolic dysfunction improves targeting for disease-modifying therapies and optimizes surveillance strategies.

Study Background