Figure 1. A re-depiction of the current “staging” model for type 1 diabetes.

Following decades of natural history studies of type 1 diabetes (i.e., monitoring the period prior to and after traditional disease diagnosis), a consensus group within the community of type 1 diabetes developed a model whose intention was to better define risk for disease development. This model was largely developed based on analysis of both immunological (autoantibody type, number) and metabolic markers (response to glucose stimulation). Other considerations not strictly considered in this published model are those of having a relative with the disease, relative relationship, age, and more. Here we depict emerging concepts related to recent studies of pancreatic pathology to improve the staging of type 1 diabetes, as described herein. Adapted from Insel, et al.³ with insets from Figures 2–3.