T1D Is a Staged Disease, Not a Sudden Diagnosis

In this video, PA Ashlyn Smith explains why type 1 diabetes is a progressive, staged autoimmune disease rather than a sudden diagnosis. She reviews the three stages of T1D, the role of autoantibodies, and how early identification allows PAs to educate patients, assess risk, and reduce the likelihood of life-threatening complications like diabetic ketoacidosis.

Key Takeaways:

There are 3 stages of T1D; in these stages, autoimmunity is present and disease progresses as beta cell mass and function decline.
Stages 1 and 2 are considered to be pre-clinical, with typical manifestations of diabetes appearing in stage 3.
Staging T1D helps us to understand risk and lay a foundation of education.

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Speaker

Click on the photo below to learn more about the speaker.

Ashlyn Smith, MMS, PA-C, DipACLM, BC-ADM, DFAAPA

References and Additional Resources:

Insel RA, Dunne JL, Atkinson MA, et al. Staging presymptomatic type 1 diabetes: a scientific statement of JDRF, the Endocrine Society, and the American Diabetes Association. Diabetes Care. 2015;38(10):1964-1974. https://diabetesjournals.org/care/article/38/10/1964/37704/Staging-Presymptomatic-Type-1-Diabetes-A

Katsarou A, Gudbjornsdottir S, Rawshani A, et al. Type 1 diabetes mellitus. Nat Rev Dis Primers. 2017;3:17016. https://pubmed.ncbi.nlm.nih.gov/28358037/

Breakthrough T1D. Early Detection of Type 1 Diabetes (T1D). Accessed February, 2026. https://cdn.prod.website-files.com/65259d558f843bc1e8837076/6674645b702a06619c491584_Breakthrough%20T1D%20Two%20Pager.pdf

Barbara Davis Center. What is Type 1 Diabetes? Accessed February, 2026. https://medschool.cuanschutz.edu/barbara-davis-center-for-diabetes/about-t1d/what-is-t1d

American Diabetes Association. Type 1 Diabetes Toolkit. Accessed February, 2026. https://professional.diabetes.org/sites/dpro/files/2024-12/121724_T1D_Toolkit.pdf

Supported by

Ashlyn Smith, MMS, PA-C, DipACLM, BC-ADM, DFAAPA

Ashlyn Smith is a board-certified physician associate, Certified Lifestyle Medicine Professional, Board Certified in Advanced Diabetes Management, and Distinguished Fellow of the American Academy of PAs with 15 years of clinical expertise in whole-person endocrine care and over a decade of commitment to medical education.

Ashlyn is the founder of ELM Endocrinology & Lifestyle Medicine, PLLC. She co-launched the Independent PA Collective, supporting PAs in starting and scaling innovative, independent healthcare and other PA-led ventures. She is Past President of the American Society of Endocrine Physician Assistants and adjunct faculty at Midwestern University. In addition to clinical care, Ashlyn is an author and frequent speaker at state and national conferences.