Evidence map›Paper›PMID 40437730›Full record

SynthesisDiabetic medicine : a journal of the British Diabetic Association2025

Testing methods used to predict disease progression in children with early-stage type 1 diabetes: A systematic review and meta-analysis.

Rabbi Swaby, Kruthika Narayan, Claire Scudder, Julia Townson, Richard A Oram, Kirstine J Bell, Maria E Craig, Colin Dayan, Paul Aveyard, Rachel E J Besser

Abstract readSystematic ReviewMeta-Analysis
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Diabetic medicine : a journal of the British Diabetic Association, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 2 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 2 syntheses or guidelines pooled it.

  1. Guideline
  2. Pooled it
  3. Article
  4. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Rabbi SwabyCentre for Human Genetics, Nuffield Department of Medicine, NIHR Oxford Biomedical Research Centre, University of Oxford, Oxford, UK.ORCID https://orcid.org/0000-0001-5815-7279
Kruthika NarayanCharles Perkins Centre and Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia.
Claire ScudderCentre for Human Genetics, Nuffield Department of Medicine, NIHR Oxford Biomedical Research Centre, University of Oxford, Oxford, UK.ORCID https://orcid.org/0000-0002-2934-4427
Julia TownsonCentre for Trials Research, Cardiff University, Cardiff, UK.
Richard A OramNIHR Exeter Biomedical Research Centre, University of Exeter, Exeter, UK.ORCID https://orcid.org/0000-0003-3581-8980
Kirstine J BellCharles Perkins Centre and Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia.ORCID https://orcid.org/0000-0001-5638-4048
Maria E CraigCharles Perkins Centre and Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia.
Colin DayanCentre for Human Genetics, Nuffield Department of Medicine, NIHR Oxford Biomedical Research Centre, University of Oxford, Oxford, UK.
Paul AveyardNuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.
Rachel E J BesserCentre for Human Genetics, Nuffield Department of Medicine, NIHR Oxford Biomedical Research Centre, University of Oxford, Oxford, UK.ORCID https://orcid.org/0000-0002-4645-6324

Funding

Novo Nordisk UK Research Foundation
6 · The paper itself

Abstract

aimsCurrent guidance on how best to monitor children and young people (CYP) with early-stage type 1 diabetes is evidenced mainly by expert consensus. This systematic review and meta-analysis aims to evaluate the current evidence for tests used to predict disease progression.

methodsData were sourced from PubMed, Cochrane Central, Ovid Embase and Scopus. The association (hazard ratio [HR]) between test positivity and progression to stage 3 type 1 diabetes in CYP aged ≤18 years with ≥2 islet autoantibodies was examined. Data were pooled using random effects models, and the Hartung-Knapp-Sidik-Jonkman (HKSJ) method was used to adjust confidence intervals to account for greater uncertainty. The risk of bias was evaluated using the QUADAS-2 tool (CRD42023393960).

resultsIn this study, 12,923 studies were identified and 285 underwent full-text review. Thirty-four studies (n = 6866 CYP, median age 11.8 years [IQR, 6.6-13.8]) were included. Overall, 2080 (30%) CYP progressed to stage 3 type 1 diabetes over a median follow-up of 5 years (IQR 2-5). The pooled HR for tests that predicted progression were: 1.40 (95% CI 1.07-1.84) for fasting glucose (OGTT), 3.19 (1.75-5.82) for 2-h glucose (OGTT), 6.43 (1.21-34.18) for the M120 above the median value, 3.12 (2.19-4.43) per 1-unit increase in Index 60 and 1.40 (1.17-1.68) per 1.1 mmol/mol increase in HbA1c (C-statistics 0.7-0.8). Evidence for other tests, including CGM, was uncertain.

conclusionsThe OGTT, its related tests (M120, Index60) and HbA1c predict progression to stage 3 in CYP with early-stage type 1 diabetes. Other tests, including CGM, need more evidence to support their use as predictive tests in this context.

Indexed as

Diabetes Mellitus, Type 1AdolescentAutoantibodiesBlood GlucoseChildDisease ProgressionGlycated HemoglobinHumansPredictive Value of TestsAutoantibodiesBlood GlucoseGlycated Hemoglobinautoimmunitychildren and adolescentsprediction of diabetestype 1 diabetes

Identifiers

PMID40437730
PMCPMC12352723

What Socratic holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.