What Have Slow Progressors Taught Us About T1D—Mind the Gap!

Kathleen M. Gillespie*, Anna E. Long

*Corresponding author for this work

Research output: Contribution to journalReview article (Academic Journal)peer-review

2 Citations (Scopus)
128 Downloads (Pure)


Purpose of Review: Progression rate from islet autoimmunity to clinical diabetes is unpredictable. In this review, we focus on an intriguing group of slow progressors who have high-risk islet autoantibody profiles but some remain diabetes free for decades. Recent Findings: Birth cohort studies show that islet autoimmunity presents early in life and approximately 70% of individuals with multiple islet autoantibodies develop clinical symptoms of diabetes within 10 years. Some “at risk” individuals however progress very slowly. Recent genetic studies confirm that approximately half of type 1 diabetes (T1D) is diagnosed in adulthood. This creates a conundrum; slow progressors cannot account for the number of cases diagnosed in the adult population. Summary: There is a large “gap” in our understanding of the pathogenesis of adult onset T1D and a need for longitudinal studies to determine whether there are “at risk” adults in the general population; some of whom are rapid and some slow adult progressors.

Original languageEnglish
Article number99
Number of pages8
JournalCurrent diabetes reports
Publication statusPublished - 1 Oct 2019


  • Adult onset
  • Islet autoantibodies
  • Slow progression
  • Type 1 diabetes (T1D)


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