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Article History

Received: 10 February 2025

Accepted: 24 April 2025

First Online: 30 July 2025

Acknowledgments

: Editorial support services for this article were provided by Debbie Kendall of Kendall Editorial in Richmond, VA. The authors thank Dr Emily Anderson-Baucum of Indiana University School of Medicine for her helpful edits and comments. The contributions of SJR and RDL were made in collaboration with the UK T1D Research Consortium. Portions of the content were presented at a symposium at the ADA’s 84th Scientific Sessions on 24 June 2024 in Orlando, FL, USA. A video presentation is included in the ESM (ESM Video ).

: The 2024 Diabetes, Diabetes Care, and Diabetologia Expert Forum ‘The Heterogeneity of Type 1 Diabetes: Pathogenesis, Prevention, and Treatment’, including a subsequent symposium presented on this topic and the preparation of this article, was supported by the Novo Nordisk Foundation (grant number NNF24SA0092023). JRM is supported by National Institutes of Health grants R01DK114233, UG3DK142188, R01DK127497, and R01DK138469; Breakthrough T1D grants 3-SRA-2023-1295-S-B and 3-SRA-2024-1555-S-B; the Edward J. Mallinckrodt Foundation; and the Anita Palmer Corbin Trust. MJR is supported by the National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases grants R01 DK124395 and R01 DK121843. SJR is supported by a Steve Morgan Foundation/Diabetes UK/Breakthrough T1D Grand Challenge Senior Research Fellowship (22/0006504).

: CE-M has served on advisory boards related to type 1 diabetes research clinical trial initiatives for Avotres, DiogenX, Dompe Pharmaceuticals, Isla Technologies, MaiCell Technologies, and Provention Bio and holds a patent (16/291,668) for Extracellular Vesicle Ribonucleic Acid (RNA) Cargo as a Biomarker of Hyperglycaemia and Type 1 Diabetes and a provisional patent (63/285,765) for Biomarker for Type 1 Diabetes (PDIA1 as a biomarker of β-cell stress). ÅL is on the Advisory Board of Diamyd. CM serves or has served on advisory panels for Abbott, Bayer, Biomea Fusion, Boehringer Ingelheim, Dexcom, Eli Lilly, Insulet, Medtronic, Novartis, Novo Nordisk, Roche, SAB Bio, Sanofi, and Vertex and serves or has served on speakers bureaus for Abbott, Boehringer Ingelheim, Dexcom, Eli Lilly, Medtronic, Novo Nordisk, Sanofi, and Vertex. Financial compensation for these activities has been received by her institution, which has also received support for her research from ActoBio Therapeutics, Medtronic, Novo Nordisk, and Sanofi. She is also president of the European Association for the Study of Diabetes (EASD). External support of EASD can be found online at . JRM is an inventor on patents and patent applications related to SC-islets, was employed at Sana Biotechnology, and has stock in Sana Biotechnology. RGM serves on the scientific advisory board for Veralox Therapeutics; holds a patent (US 10,738,343 B2) for ‘Extracellular Vesicle Ribonucleic Acid (RNA) Cargo as a Biomarker of Hyperglycemia and Type 1 Diabetes and a patent (US 11,268,148 B2) for ‘DNA Methylation in Inflammatory Disease’; and has received investigator-initiated grants from Hibercell, Inc., and Veralox Therapeutics. FP has served on advisory boards related to type 1 diabetes screening for Sanofi. MJR is a member of the Editorial Board of Diabetologia. SSR is a consultant for the Administrative Coordinating Center for the National Heart, Lung, and Blood Institute Trans-Omics for Precision Medicine (TOPMed) programme and Westat and has received lecture fees from Sanofi. MRR has received consulting fees from Novo Nordisk, Sernova Corp., and Vertex Pharmaceuticals, Inc.; speaker honoraria from Bayer Healthcare Co.; and research support from Dompé farmaceutici S.p.A. and Tandem Diabetes. RDL is on the Advisory Board of Diamyd. All other authors declare that there are no relationships or activities that might bias, or be perceived to bias, their work.

: All authors contributed to writing, reviewing, and revising the first draft of the manuscript; CE-M and RDL substantively edited the manuscript; and all authors reviewed, revised, and approved the final version for submission. CE-M and RDL are the guarantors of this work and, as such, take responsibility for the integrity of the review.