1. Predicting Type 1 Diabetes Using Biomarkers Featured Article: Ezio Bonifacio Diabetes Care Volume 38: 989-996 June, 2015

2. STUDY OBJECTIVE To propose that there is now sufficient evidence to allow a broader use of islet autoantibodies as biomarkers to diagnose type 1 diabetes already at an asymptomatic stage Attempts to prevent clinical hyperglycemia become a feature of disease management Bonifacio E. Black M. Diabetes Care 2015;38:989-996

3. STUDY DESIGN AND METHODS Prediction would shift toward the use of genetic and other biomarkers to determine the likelihood that islet autoimmunity will develop in an infant Metabolic assessment to stage preclinical diabetes and biomarkers to determine the rate of progression to hyperglycemia would follow in children diagnosed with islet autoimmunity Bonifacio E. Black M. Diabetes Care 2015;38:989-996

8. RESULTS A case is presented for future comprehensive risk assessment that commences at birth and includes attempts to predict, stage, and prevent initiation and progression of the disease process at multiple stages Biomarkers that are required to achieve this level of sophistication and dissemination are discussed Bonifacio E. Black M. Diabetes Care 2015;38:989-996

9. CONCLUSIONS It is hoped that prediction of type 1 diabetes will eventually move into a public health setting and become more comprehensive A combined risk assessment together with an “attempt-to- prevent” approach that starts from birth is encouraged Bonifacio E. Black M. Diabetes Care 2015;38:989-996