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.
