A study published in JAMA (2013) investigated the risk of progression to type 1 diabetes in children with multiple islet autoantibodies. The study pooled data from three long-term prospective cohort studies conducted in Colorado, Finland, and Germany, involving 13,377 children at genetic risk for type 1 diabetes. The primary analysis focused on children with two or more islet autoantibodies, while the secondary analysis included children with one or no autoantibodies. The study found that 69.7% of children with multiple islet autoantibodies developed type 1 diabetes within 10 years, compared to 14.5% of those with a single autoantibody and 0.4% of those with no autoantibodies by age 15. The risk of progression was higher in children who seroconverted to islet autoantibodies before age 3, those with the HLA genotype DR3/DR4-DQ8, and girls. The 10-year risk of progression was 74.9% for children who seroconverted before age 3, compared to 60.9% for those who seroconverted at age 3 or older. The study also found that the presence of multiple islet autoantibodies was a strong predictor of type 1 diabetes, with a 395.6-fold increased risk compared to children with no autoantibodies. The progression rate varied among children, with some developing diabetes within weeks and others within 18 years. The study highlights the importance of early detection of multiple islet autoantibodies as a preclinical stage of type 1 diabetes and emphasizes the need for future prevention studies targeting this high-risk population. The findings suggest that children with multiple islet autoantibodies are at significantly higher risk of developing type 1 diabetes, and further research is needed to develop interventions to prevent or delay the onset of the disease.A study published in JAMA (2013) investigated the risk of progression to type 1 diabetes in children with multiple islet autoantibodies. The study pooled data from three long-term prospective cohort studies conducted in Colorado, Finland, and Germany, involving 13,377 children at genetic risk for type 1 diabetes. The primary analysis focused on children with two or more islet autoantibodies, while the secondary analysis included children with one or no autoantibodies. The study found that 69.7% of children with multiple islet autoantibodies developed type 1 diabetes within 10 years, compared to 14.5% of those with a single autoantibody and 0.4% of those with no autoantibodies by age 15. The risk of progression was higher in children who seroconverted to islet autoantibodies before age 3, those with the HLA genotype DR3/DR4-DQ8, and girls. The 10-year risk of progression was 74.9% for children who seroconverted before age 3, compared to 60.9% for those who seroconverted at age 3 or older. The study also found that the presence of multiple islet autoantibodies was a strong predictor of type 1 diabetes, with a 395.6-fold increased risk compared to children with no autoantibodies. The progression rate varied among children, with some developing diabetes within weeks and others within 18 years. The study highlights the importance of early detection of multiple islet autoantibodies as a preclinical stage of type 1 diabetes and emphasizes the need for future prevention studies targeting this high-risk population. The findings suggest that children with multiple islet autoantibodies are at significantly higher risk of developing type 1 diabetes, and further research is needed to develop interventions to prevent or delay the onset of the disease.