{"doi":"10.1210/jcemcr/luaf317","title":"Progression from Stage 1 to Stage 3 Type 1 Diabetes Characterized by Hypoglycemia","abstract":"Type 1 diabetes (T1D) development progresses through well-defined stages based on the presence of islet autoantibodies such as insulin autoantibody, glutamic acid decarboxylase autoantibody, tyrosine phosphatase-like protein IA-2 autoantibody, and zinc transporter 8 autoantibody and glycemic status. The presence of multiple islet autoantibodies and normal glucose tolerance is considered stage 1 T1D. Progression to abnormal glucose tolerance, as measured by oral glucose tolerance test or hemoglobin A1c, is considered stage 2, and stage 3 T1D is defined by symptomatic hyperglycemia and the need for insulin replacement therapy. Here, we present a case of a 9-year-old male with rapid progression from stage 1 T1D to stage 3 T1D characterized by persistent, symptomatic hypoglycemia, concurrent with abnormal glucose tolerance. This case demonstrates the paradoxical presence of hypoglycemia and impaired glucose tolerance and suggests that hypoglycemia may be a biomarker of imminent and rapid progression to stage 3 T1D.","journal":"JCEM Case Reports","year":2025,"id":587961,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":0,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9458,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2025-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":428128,"name":"Jamie L. Felton","orcid":"0000-0002-6170-1156","position":1,"is_corresponding":false},{"id":940364,"name":"Aakash Nagarapu","orcid":"0000-0002-9940-4325","position":0,"is_corresponding":true}],"reference_count":14,"raw_metadata":null,"created_at":"2026-07-19T02:59:43.096742Z","pmid":"41837235","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}