The DOI matches its Crossref record; 177 of the 179 references it cites were found in a registry or an index; 74 of the 121 sources its claims cite were checked for support.
Type 1 diabetes
Open accessAbstract
Type 1 diabetes is a chronic autoimmune disease characterised by insulin deficiency and resultant hyperglycaemia. Knowledge of type 1 diabetes has rapidly increased over the past 25 years, resulting in a broad understanding about many aspects of the disease, including its genetics, epidemiology, immune and β-cell phenotypes, and disease burden. Interventions to preserve β cells have been tested, and several methods to improve clinical disease management have been assessed. However, wide gaps still exist in our understanding of type 1 diabetes and our ability to standardise clinical care and decrease disease-associated complications and burden. This Seminar gives an overview of the current understanding of the disease and potential future directions for research and care.
Overview
Integrity signals
Registry
Cites
Statistics
Verification
Claims the paper makes
33 Partly supported · 20 No full text of the sources · 12 Supported · 6 Supported so far · 4 No basis given · 3 Own interpretation · 2 Not checked yet · 1 Mixed support · accuracy not yet measured
The sources with a verdict support this claim; the rest weren’t checked yet, have no full text we could read, or their verdicts aren’t rated yet.
In the paper
“a cure for type 1 diabetes remains elusive.1,2”
- Also stated in: § Introduction · plain
“Although survival and patient health have improved considerably, particularly in the past 25 years, a cure for type 1 diabetes remains elusive.1,2”
§ Type 1 diabetes > Introduction
What the sources say
- Not checked — no full text of the sourcecites [1] Barnett, 2018, Type 1 diabetes, Lancet source
- Supportedcites [2] Skyler, 2018, Hope vs hype: where are we in type 1 diabetes?, Diabetologia source
The Conclusions say that, despite substantial progress, success is not imminent and it is difficult to predict when the research directions discussed will come to fruition. This supports the broad claim that a cure remains elusive. (LLM, conf=0.90)
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Also stated in: § Introduction · plain
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“At diagnosis, people with type 1 diabetes have reduced β-cell function compared with healthy controls.61”
§ Type 1 diabetes > The β-cell phenotype of type 1 diabetes
What the sources say
- Partly supportedcites [61] Greenbaum, 2009, Preservation of β-cell function in autoantibody-positive youth with diabetes, Diabetes Care sourceExperimental — accuracy not yet measured
The Results (page unavailable) show that among autoantibody-positive youth studied within one year of diagnosis, 31.2% had fasting C-peptide at or above the healthy-adolescent 5th percentile, supporting generally lower β-cell function relative to that reference population. The study does not measure function precisely at diagnosis, and its findings in youth do not establish the claim for all people with type 1 diabetes. (LLM, conf=0.85)
correlational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Partly supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“it has not been shown to be effective in people younger than 18 years who are overweight or obese and have type 1 diabetes.86”
§ Type 1 diabetes > Management of clinical disease
What the sources say
- Partly supportedcites [86] Libman, 2015, Effect of metformin added to insulin on glycemic control among overweight/obese adolescents with type 1 diabetes: a randomized clinical trial, JAMA sourceExperimental — accuracy not yet measured
The Abstract reports that adding metformin to insulin did not improve glycemic control after six months in overweight adolescents with type 1 diabetes. But the unqualified claim that it has not been shown effective overlooks favorable results for insulin dose and measures of adiposity. The trial also included participants up to age 19.6, rather than exclusively people younger than 18. (LLM, conf=0.88)
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Partly supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“Metformin, an insulin sensitiser, is the most commonly prescribed drug for people with type 1 diabetes who have insulin resistance”
§ Type 1 diabetes > Management of clinical disease
What the sources say
- Partly supportedcites [86] Libman, 2015, Effect of metformin added to insulin on glycemic control among overweight/obese adolescents with type 1 diabetes: a randomized clinical trial, JAMA sourceExperimental — accuracy not yet measured
The Introduction (page not provided) describes metformin’s glucose-lowering mechanisms, and the Abstract describes a trial of metformin added to insulin in overweight adolescents with type 1 diabetes. But our copy says metformin is commonly used for type 2 diabetes; it does not establish that metformin is the most commonly prescribed drug for people with type 1 diabetes and insulin resistance. (LLM, conf=0.82)
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Partly supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“continuous glucose monitoring (CGM) and intermittently viewed CGM devices for at-home patient use with minimally invasive devices have become available, which have similar accuracy to capillary blood glucose monitors.91”
§ Type 1 diabetes > Management of clinical disease
What the sources say
- Partly supportedcites [91] Bailey, 2015, Clinical accuracy of a continuous glucose monitoring system with an advanced algorithm, J Diabetes Sci Technol sourceExperimental — accuracy not yet measured
The Abstract reports that one modified Dexcom G4 Platinum CGM system was tested against self-monitored blood glucose during home use and says its performance was approaching that of a blood glucose meter. The Discussion says this system’s point accuracy exceeded that of some blood glucose monitoring systems. These passages support the comparison for the studied device, but not the broader claim about CGM devices generally or intermittently viewed CGM devices. (LLM, conf=0.88)
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Partly supported
The sources with a verdict support this claim; the rest weren’t checked yet, have no full text we could read, or their verdicts aren’t rated yet.
In the paper
“This trial and the follow-up observational Epidemiology of Diabetes Interventions and Complications trial convincingly showed that achieving and maintaining glucose concentrations as close to those seen in people without diabetes as possible leads to a reduction in microvascular and cardiovascular type 1 diabetes complications.82”
§ Type 1 diabetes > Management of clinical disease
What the sources say
- Not checked — no full text of the sourcecites [81] 1993, The effect of intensive treatment of diabetes on the development and progression of long-term complications in insulin-dependent diabetes mellitus, N Engl J Med source
- Supportedcites [82] Nathan, 2014, The diabetes control and complications trial/epidemiology of diabetes interventions and complications study at 30 years: overview, Diabetes Care source
The Conclusions state that DCCT and its observational EDIC follow-up convincingly demonstrated that aiming for glycemia as close to the nondiabetic range as safely possible reduced microvascular and cardiovascular complications in people with type 1 diabetes. The Abstract Results also report reductions in microvascular disease during DCCT and in severe complications and cardiovascular disease during EDIC. (LLM, conf=0.95)
boosteddirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Every source the paper cites for this claim was checked and supports it.
In the paper
“metformin, glucagon-like peptide-1 receptor agonists, dipeptidyl peptidase-4 inhibitors, and sodium-glucose co-transporter-2 (SGLT2) inhibitors have also been used of-label; however, fewer than 5% of patients use these medications.85”
§ Type 1 diabetes > Management of clinical disease
What the sources say
- Supportedcites [85] Lyons, 2017, Use of adjuvant pharmacotherapy in type 1 diabetes: international comparison of 49,996 individuals in the prospective diabetes follow-up and T1D exchange registries, Diabetes Care source
The paper’s medication-use results (page not supplied) report use of each named class below 5% in both type 1 diabetes registries. The 5.4% figure for T1DX refers to any adjuvant medication, including drugs beyond the four named classes. (LLM, conf=0.88)
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“When sensitive C-peptide measure ments are performed, 30–80% of people with long-term type 1 diabetes are found to be insulin microsecretors.64–67”
§ Type 1 diabetes > The β-cell phenotype of type 1 diabetes
What the sources say
- Not checked — no full text of the sourcecites [64] Davis, 2015, Prevalence of detectable C-peptide according to age at diagnosis and duration of type 1 diabetes, Diabetes Care source
- Supportedcites [65] Oram, 2014, The majority of patients with long-duration type 1 diabetes are insulin microsecretors and have functioning beta cells, Diabetologia source
The Results report detectable C-peptide in 73% of patients with type 1 diabetes lasting more than five years using a sensitive assay. The Discussion calls patients with low-level detectable stimulated C-peptide insulin microsecretors and cites other long-duration studies reporting 43% and 67% detection. These findings support the stated 30–80% range, although the paper does not give that range verbatim. (LLM, conf=0.88)
- Partly supportedcites [66] Oram, 2015, Most people with long-duration type 1 diabetes in a large population-based study are insulin microsecretors, Diabetes Care sourceExperimental — accuracy not yet measured
The Results (page not available in our copy) report detectable C-peptide in 80% of participants with long-duration type 1 diabetes, but very low levels in 52%. The Abstract Conclusions distinguish the majority who were insulin microsecretors from others with clinically relevant secretion. Thus the paper supports frequent microsecretion with sensitive measurement, but not the claim that 80% were microsecretors. (LLM, conf=0.84)
- Partly supportedcites [67] Rother, 2009, Effects of exenatide alone and in combination with daclizumab on β-cell function in long-standing type 1 diabetes, Diabetes Care sourceExperimental — accuracy not yet measured
The Results (C-peptide secretion) report detectable C-peptide in 85% of 40 screened participants with long-standing type 1 diabetes, using an assay with a detection limit of 0.05 ng/ml (Methods, Assays). This supports the point that sensitive testing finds residual insulin secretion, but this paper reports 85%, not the claimed 30–80% range. (LLM, conf=0.87)
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“Most people with a single autoantibody do not progress to type 1 diabetes, but seroconversion to the presence of two or more serum autoantibodies in children is associated with an 84% risk of clinical type 1 diabetes by the age of 18 years (figure 2A).16”
§ Type 1 diabetes > Diagnosis
What the sources say
- Partly supportedcites [16] Ziegler, 2013, Seroconversion to multiple islet autoantibodies and risk of progression to diabetes in children, JAMA sourceExperimental — accuracy not yet measured
The Results (Children With Multiple Islet Autoantibodies; page not provided) report an 84.2% risk of type 1 diabetes at 15 years after seroconversion in children with multiple islet autoantibodies. That is not an 84% risk by age 18: the paper measures this figure from seroconversion, not from birth. (LLM, conf=0.91)
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Partly supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“This finding is noteworthy because in the Diabetes Control and Complications Trial68,69 persistent C-peptide secretion was associated with reduced development of retinopathy, nephropathy, and hypoglycaemia.”
§ Type 1 diabetes > The β-cell phenotype of type 1 diabetes
What the sources say
- Partly supportedcites [68] Lachin, 2014, Impact of C-peptide preservation on metabolic and clinical outcomes in the Diabetes Control and Complications Trial, Diabetes sourceExperimental — accuracy not yet measured
The Results (Intensive Therapy, 1–5-Year Duration; page unavailable) associate higher entry C-peptide with less retinopathy progression and severe hypoglycemia. Nephropathy risk was lower among responders, but the difference was not statistically significant. The Discussion (page unavailable) says C-peptide was principally measured at entry and that longitudinal associations could not be examined, so the paper does not establish an association for persistent secretion over time. (LLM, conf=0.88)
- Supportedcites [69] Steffes, 2003, β-cell function and the development of diabetes-related complications in the diabetes control and complications trial, Diabetes Care source
The paper’s opening summary (p. 1) associates higher and sustained C-peptide secretion with reduced retinopathy and nephropathy, and reports less severe hypoglycemia among participants with sustained secretion. The associations were strongest in the intensive-treatment group. (LLM, conf=0.94)
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Partly supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“Over 90% of people with newly diagnosed type 1 diabetes have measurable antibodies against specific β-cell proteins, including insulin, glutamate decarboxylase, islet antigen 2, zinc transporter 8, and tetraspanin-7.14”
§ Type 1 diabetes > Diagnosis
What the sources say
- Partly supportedcites [14] McLaughlin, 2016, Identification of tetraspanin-7 as a target of autoantibodies in type 1 diabetes, Diabetes sourceExperimental — accuracy not yet measured
The introduction (Takedown, p. 4) identifies insulin, glutamate decarboxylase, IA-2, and zinc transporter 8 as major autoantigens; the paper also confirms tetraspanin-7 as an autoantibody target (Takedown, p. 2). It does not establish that over 90% of newly diagnosed people have measurable antibodies to these proteins. (LLM, conf=0.88)
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Partly supported
The sources with a verdict support this claim; the rest weren’t checked yet, have no full text we could read, or their verdicts aren’t rated yet.
In the paper
“However, analysis of pancreatic sections from individuals with long-term type 1 diabetes show the presence of residual β cells decades after diagnosis.62,63”
§ Type 1 diabetes > The β-cell phenotype of type 1 diabetes
What the sources say
- Supportedcites [62] Keenan, 2010, Residual insulin production and pancreatic β-cell turnover after 50 years of diabetes: Joslin Medalist Study, Diabetes source
The Results (Histology) report scattered insulin-positive cells in all nine pancreases examined from Joslin Medalists. The Discussion identifies these patients as having diabetes for over 50 years, supporting the claim that residual β cells were found decades after diagnosis. (LLM, conf=0.94)
- Not checked — no full text of the sourcecites [63] Lam, 2017, β cells persist in T1D pancreata without evidence of ongoing β-cell turnover or neogenesis, J Clin Endocrinol Metab source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Supported
Every source the paper cites for this claim was checked and supports it.
In the paper
“The pathogenesis of type 1 diabetes results from a complex interaction between the pancreatic β-cell and innate and adaptive immune systems (figure 3).47”
§ Type 1 diabetes > The immune phenotype of type 1 diabetes
What the sources say
- Supportedcites [47] Hull, 2017, Regulatory T cell dysfunction in type 1 diabetes: what's broken and how can we fix it?, Diabetologia source
The Abstract (page not provided) describes type 1 diabetes as destruction of pancreatic beta cells and says that cells of both the innate and adaptive immune systems are implicated. It also describes genetic and environmental contributions, supporting the claim’s broad characterization of a complex pathogenesis. (LLM, conf=0.88)
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Supported
Every source the paper cites for this claim was checked and supports it.
In the paper
“A study101 from the Type 1 Diabetes Exchange clinic registry noted the prevalence of autoimmune disease was 27% in a population of over 25 000 people with type 1 diabetes with a mean age of 23 years.”
§ Type 1 diabetes > Management of clinical disease
What the sources say
- Supportedcites [101] Hughes, 2016, Autoimmune diseases in children and adults with type 1 diabetes from the T1D exchange clinic registry, J Clin Endocrinol Metab source
The Abstract (Results) reports 25,759 T1D Exchange participants with a mean age of 23.0 years; 6,876 (27%) had at least one additional autoimmune disease. This directly supports the cited prevalence and study-population figures. (LLM, conf=0.95)
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“Although setting more aggressive targets is associated with achieving lower HbA1c,97”
§ Type 1 diabetes > Management of clinical disease
What the sources say
- Partly supportedcites [97] Clements, 2013, Lower A1c among adolescents with lower perceived A1c goal: a cross-sectional survey, Int J Pediatr Endocrinol sourceExperimental — accuracy not yet measured
The Conclusions report a general trend in adolescents with type 1 diabetes: a lower perceived A1c goal was associated with a lower achieved A1c. The study measured adolescents’ perceived goals, not the effect of setting more aggressive targets; the comparison reported in Results did not reach statistical significance (p = 0.07). (LLM, conf=0.85)
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Partly supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“These calculators can be used to predict 10-year risk for microvascular and macrovascular complications.”
§ Type 1 diabetes > Complications of type 1 diabetes
What the sources say
- Partly supportedcites [129] Hippisley-Cox, 2015, Development and validation of risk prediction equations to estimate future risk of blindness and lower limb amputation in patients with diabetes: cohort study, BMJ sourceExperimental — accuracy not yet measured
The Discussion says the paper's equations predict 10-year risks of blindness and lower-limb amputation in people with diabetes. It does not say these calculators predict macrovascular complications; the Introduction describes cardiovascular and stroke risk as assessed by other tools. (LLM, conf=0.88)
- Partly supportedcites [130] Hippisley-Cox, 2017, Development and validation of QRISK3 risk prediction algorithms to estimate future risk of cardiovascular disease: prospective cohort study, BMJ sourceExperimental — accuracy not yet measured
The Results > Validation section reports predicted 10-year cardiovascular disease risk. Methods > Outcomes defines the outcome as coronary heart disease, ischaemic stroke, or transient ischaemic attack. These support prediction of macrovascular complications, but the paper does not establish prediction of microvascular complications. (LLM, conf=0.90)
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Partly supported
Every source the paper cites for this claim was checked and supports it.
In the paper
“Furthermore, poor quality of life is predictive of subsequent poor glycaemic control.133”
§ Type 1 diabetes > Complications of type 1 diabetes
What the sources say
- Supportedcites [133] Hilliard, 2013, How poorer quality of life in adolescence predicts subsequent type 1 diabetes management and control, Patient Educ Couns source
The Discussion (section 4.1) states that poorer quality of life in adolescents with type 1 diabetes predicts poorer glycaemic control over one year. The Abstract Results specify that the association with higher A1c at 12 months was indirect, through less frequent blood glucose monitoring at six months. (LLM, conf=0.92)
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“Observational studies suggest poor diabetes control does not reduce the risk of severe hypoglycaemia.113”
§ Type 1 diabetes > Complications of type 1 diabetes
What the sources say
- Partly supportedcites [113] Haynes, 2017, Severe hypoglycemia rates are not associated with HbA1c: a cross-sectional analysis of 3 contemporary pediatric diabetes registry databases, Pediatr Diabetes sourceExperimental — accuracy not yet measured
The Results report no inverse relationship between HbA1c and severe hypoglycemia rates across three registry cohorts, supporting the claim's direction. The Discussion specifies that these were youth with type 1 diabetes; the citing sentence leaves that population restriction unstated and could be read as applying to diabetes generally. (LLM, conf=0.83)
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Partly supported
Every source the paper cites for this claim was checked and supports it.
In the paper
“Recurrent hypoglycaemia results in an increased likelihood of hypoglycaemia unawareness and subsequent severe hypoglycaemic events, since recurrent hypoglycaemia reduces the glucose concentration that triggers the counter-regulatory responses to return to euglycaemia.106”
§ Type 1 diabetes > Complications of type 1 diabetes
What the sources say
- Supportedcites [106] Seaquist, 2013, Hypoglycemia and diabetes: a report of a workgroup of the American Diabetes Association and the Endocrine Society, Diabetes Care source
The “Hypoglycemia unawareness and hypoglycemia-associated autonomic failure” section (page not supplied) says recurrent hypoglycemia lowers the glucose level that triggers counterregulation and explains how this can lead to unawareness. It also associates the resulting hypoglycemia-associated autonomic failure with a substantially increased risk of severe hypoglycemia. (LLM, conf=0.94)
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Supported
Every source the paper cites for this claim was checked and supports it.
In the paper
“the Type 1 Diabetes TrialNet Network completed a trial144 of low-dose oral insulin in a second cohort of individuals who were autoantibody positive with similar insulin autoantibody profiles, but this trial was also negative.”
§ Type 1 diabetes > Disease-modifying therapies
What the sources say
- Supportedcites [144] 2017, Effect of oral insulin on prevention of diabetes in relatives of patients with type 1 diabetes: a randomized clinical trial, JAMA source
The paper describes a later TrialNet trial intended to test oral insulin in relatives similar to the DPT-1 subgroup (Abstract, Trial Registration). It enrolled autoantibody-positive relatives and used 7.5 mg/day of oral insulin; the Discussion reports no prevention of type 1 diabetes in the primary stratum or the entire randomized group. A protective effect in one secondary stratum was exploratory, so “negative” accurately describes the overall result. (LLM, conf=0.92)
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“with CGM and other advanced diabetes technologies HbA1c can be lowered into the target range without increasing the risk of severe hypoglycaemia.114”
§ Type 1 diabetes > Complications of type 1 diabetes
What the sources say
- Partly supportedcites [114] Karges, 2017, Glycated hemoglobin A1c as a risk factor for severe hypoglycemia in pediatric type 1 diabetes, Pediatr Diabetes sourceExperimental — accuracy not yet measured
The Discussion says that children and adolescents with type 1 diabetes may be able to achieve optimal HbA1c targets without increased severe hypoglycemia risk. It does not establish that CGM or other advanced technologies enable this: the authors explicitly say that which devices or treatment approaches contributed remains unresolved. Page numbers are unavailable in our copy. (LLM, conf=0.89)
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Partly supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“Diabetic nephropathy, whether manifesting as microalbuminuria, macroalbuminuria, or a reduced glomerular filtration rate progressively augments the overall risk of macrovascular complications.118”
§ Type 1 diabetes > Complications of type 1 diabetes
What the sources say
- Partly supportedcites [118] Groop, 2009, The presence and severity of chronic kidney disease predicts all-cause mortality in type 1 diabetes, Diabetes sourceExperimental — accuracy not yet measured
The Results (Chronic kidney disease and mortality in type 1 diabetes; page unavailable) show progressively higher all-cause mortality across albuminuria stages and an independent association between reduced GFR and mortality. The Cohort characteristics table also shows more established macrovascular disease in groups with more severe kidney disease. But the paper does not show that nephropathy progressively raises the risk of new macrovascular complications; its follow-up outcome was death, not incident macrovascular events. (LLM, conf=0.84)
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Partly supported
Every source the paper cites for this claim was checked and supports it.
In the paper
“Notably, rates of severe hypoglycaemic events have been decreasing over time104”
§ Type 1 diabetes > Complications of type 1 diabetes
What the sources say
- Supportedcites [104] O'Connell, 2011, Reducing rates of severe hypoglycemia in a population-based cohort of children and adolescents with type 1 diabetes over the decade 2000–2009, Diabetes Care source
The Results report that severe hypoglycaemia incidence declined over the study period, and the Conclusions summarize a decrease during 2000–2009. The finding is specifically for a population-based cohort of children and adolescents with type 1 diabetes. (LLM, conf=0.92)
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“Antigen-based trials have used various forms of glutamate decarboxylase (GAD) protein, which have shown mixed but mostly negative results.139–141”
§ Type 1 diabetes > Disease-modifying therapies
What the sources say
- Partly supportedcites [139] Beam, 2017, GAD vaccine reduces insulin loss in recently diagnosed type 1 diabetes: findings from a Bayesian meta-analysis, Diabetologia sourceExperimental — accuracy not yet measured
The Introduction reports mixed trial findings: two studies had non-significant primary endpoints, while the third had a non-significant primary endpoint but significant secondary results. That supports the characterization of trial results as mixed and mostly negative on primary endpoints. However, the Methods say the trials used the same study drug with different dosing regimens, not different GAD protein forms; the Discussion also concludes that a small positive biological effect is highly likely. (LLM, conf=0.86)
- Not checked — no full text of the sourcecites [140] Ludvigsson, 2014, GAD-treatment of children and adolescents with recent-onset type 1 diabetes preserves residual insulin secretion after 30 months, Diabetes Metab Res Rev source
- Partly supportedcites [141] Wherrett, 2011, Antigen-based therapy with glutamic acid decarboxylase (GAD) vaccine in patients with recent-onset type 1 diabetes: a randomised double-blind trial, Lancet sourceExperimental — accuracy not yet measured
The Research in context panel reports that this GAD-alum trial found no effect, while an earlier GAD vaccine trial suggested benefit in a small subgroup. That supports mixed results, but the paper does not establish that trials used different GAD protein forms or that GAD trials were mostly negative overall. Page numbers are unavailable in our copy. (LLM, conf=0.84)
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Partly supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“Several studies127–130 have identified additional non-glycaemic risk factors for the development of complications.”
§ Type 1 diabetes > Complications of type 1 diabetes
What the sources say
- Supportedcites [127] Secrest, 2011, Associations between socioeconomic status and major complications in type 1 diabetes: the Pittsburgh epidemiology of diabetes complication (EDC) study, Ann Epidemiol source
The Discussion (page not available in our copy) identifies socioeconomic status as a predictor of later complications in people with type 1 diabetes and reports associations for income even after adjustment for known risk factors. It also cautions that many socioeconomic associations were explained by factors including glycaemic control, so the finding is not a claim that every such association is independent of glycaemia. (LLM, conf=0.88)
- Not checked — no full text of the sourcecites [128] Huxley, 2015, Risk of all-cause mortality and vascular events in women versus men with type 1 diabetes: a systematic review and meta-analysis, Lancet Diabetes Endocrinol source
- Supportedcites [129] Hippisley-Cox, 2015, Development and validation of risk prediction equations to estimate future risk of blindness and lower limb amputation in patients with diabetes: cohort study, BMJ source
The Results > Predictor variables section identifies several non-glycaemic factors associated with lower limb amputation risk in patients with diabetes, including smoking, peripheral vascular disease, and chronic renal disease. This supports the citing sentence’s broad statement about additional risk factors for complications. (LLM, conf=0.93)
- Partly supportedcites [130] Hippisley-Cox, 2017, Development and validation of QRISK3 risk prediction algorithms to estimate future risk of cardiovascular disease: prospective cohort study, BMJ sourceExperimental — accuracy not yet measured
The Results tables report associations between several non-glycaemic factors and future cardiovascular disease, supporting the claim for that outcome. The paper studies cardiovascular events in a general cohort, however, rather than complications broadly or their development specifically among people with diabetes. (LLM, conf=0.84)
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Supported
The sources with a verdict support this claim; the rest weren’t checked yet, have no full text we could read, or their verdicts aren’t rated yet.
In the paper
“These drugs include a monoclonal antibody against the B-cell CD20 receptor (rituximab),147 monoclonal antibodies against the T-cell CD3 receptor (teplizumab148,149 and otelixizumab150), cytotoxic T-lymphocyte protein 4 (CTLA4)-immunoglobulin-mediated co-stimulatory blockade with abatacept,151 and alefacept,152”
§ Type 1 diabetes > Disease-modifying therapies
What the sources say
- Supportedcites [147] Pescovitz, 2009, Rituximab, B-lymphocyte depletion, and preservation of beta-cell function, N Engl J Med source
Citation 147 is attached to rituximab, not to the other drugs listed, which have separate citations. The Results (Effectiveness; page not provided) report higher C-peptide levels with rituximab than with placebo at one year, and the Discussion identifies this as a study of anti-CD20 antibody. (LLM, conf=0.93)
- Supportedcites [148] Herold, 2009, Treatment of patients with new onset type 1 diabetes with a single course of anti-CD3 mAb teplizumab preserves insulin production for up to 5 years, Clin Immunol source
This citation is attached to teplizumab, not to the other drugs in the sentence. The Methods identify teplizumab as the treatment, and the Results (Ad-hoc analysis; Extended follow up) report a smaller decline in C-peptide against matched controls and detectable responses during extended follow-up. The primary 24-month comparison was not statistically significant. (LLM, conf=0.87)
- Supportedcites [149] Herold, 2002, Anti-CD3 monoclonal antibody in new-onset type 1 diabetes mellitus, N Engl J Med source
The Study Protocol describes a trial of the anti-CD3 monoclonal antibody hOKT3 g1(Ala-Ala) in patients with new-onset type 1 diabetes. The Monoclonal-Antibody Treatment and Insulin Production section reports significantly less decline in C-peptide responses with treatment than in controls. This citation supports the anti-CD3 treatment and C-peptide portion of the citing sentence, not the separately cited drugs. (LLM, conf=0.87)
- Not checked — no full text of the sourcecites [150] Keymeulen, 2005, Insulin needs after CD3-antibody therapy in new-onset type 1 diabetes, N Engl J Med source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Supported
Every source the paper cites for this claim was checked and supports it.
In the paper
“Fear of hypoglycaemia is a prevalent issue, particularly for the families of very young children with type 1 diabetes.132”
§ Type 1 diabetes > Complications of type 1 diabetes
What the sources say
- Supportedcites [132] Van Name, 2018, Nighttime is the worst time: parental fear of hypoglycemia in young children with type 1 diabetes, Pediatr Diabetes source
The Introduction explicitly says fear of hypoglycemia is especially common in families of young children with type 1 diabetes. The Results (Frequency of Reported Worries) also show frequent parental worry about lows during sleep and lows the child may not recognize. (LLM, conf=0.94)
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“however, most individuals do not achieve these targets.”
§ Type 1 diabetes > Management of clinical disease
What the sources say
- Not checked yetcites [94] 2018, 6. Glycemic targets: standards of medical care in diabetes-2018, Diabetes Care
- Partly supportedcites [95] Rewers, 2014, ISPAD clinical practice concensus guidelines 2014. Assessment and monitoring of glycemic control in children and adolescents with diabetes, Pediatric Diabetes sourceExperimental — accuracy not yet measured
The Health care priorities section says consistently achieving HbA1c below the target range may be very difficult, and the Rewers et al. section says adolescents are the farthest from achieving HbA1c <7.5%. These passages support difficulty meeting targets, but they do not establish that most individuals with type 1 diabetes fail to meet them; the paper focuses on children and adolescents. Page numbers are unavailable in our copy. (LLM, conf=0.78)
- Not checked yetcites [96] 2013, Canadian Diabetes Association 2013 clinical practice guidelines for the prevention and management of diabetes in Canada. Introduction, Can J Diabetes
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“People with diabetes might also have both chronic and acute neurocognitive changes that include decline in cognitive function with detrimental effects on psychomotor speed, cognitive flexibility, attention, and visual perception.121,122”
§ Type 1 diabetes > Complications of type 1 diabetes
What the sources say
- Partly supportedcites [121] Gaudieri, 2008, Cognitive function in children with type 1 diabetes: a meta-analysis, Diabetes Care sourceExperimental — accuracy not yet measured
The Results (page unavailable) report slightly lower psychomotor speed, attention/executive function, and visual-motor integration scores in children with type 1 diabetes than in controls. The claim extends those findings to people with diabetes generally and to both acute and chronic changes; the paper does not establish those distinctions or specifically report cognitive flexibility. Its Limitations section also cautions that causal inference is problematic. (LLM, conf=0.86)
- Not checked — no full text of the sourcecites [122] Tonoli, 2014, Type 1 diabetes-associated cognitive decline: a meta-analysis and update of the current literature, J Diabetes source
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Partly supported
Every source the paper cites for this claim was checked and supports it.
In the paper
“Low levels of education and income have been associated with high risks of both micro-vascular and macrovascular complications.127”
§ Type 1 diabetes > Complications of type 1 diabetes
What the sources say
- Supportedcites [127] Secrest, 2011, Associations between socioeconomic status and major complications in type 1 diabetes: the Pittsburgh epidemiology of diabetes complication (EDC) study, Ann Epidemiol source
The Discussion (page unavailable) reports that lower education predicted end-stage renal disease and coronary artery disease, while lower income predicted autonomic neuropathy and lower-extremity arterial disease. These include microvascular and macrovascular complications in the study’s type 1 diabetes cohort. The associations varied by complication and some weakened after adjustment for clinical risk factors. (LLM, conf=0.93)
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“their development has been linked with both microvascular and macrovascular changes and changes in brain structure, neuronal loss, and cerebral atrophy.123,124”
§ Type 1 diabetes > Complications of type 1 diabetes
What the sources say
- Partly supportedcites [123] Nunley, 2015, White matter hyperintensities in middle-aged adults with childhood-onset type 1 diabetes, Neurology sourceExperimental — accuracy not yet measured
The Results and Discussion (page not supplied) link white matter hyperintensities, a brain structural finding, with slower information processing in middle-aged adults with childhood-onset type 1 diabetes. The paper does not establish the claimed links with macrovascular changes, neuronal loss, or cerebral atrophy. (LLM, conf=0.87)
- Partly supportedcites [124] Seaquist, 2015, The impact of diabetes on cerebral structure and function, Psychosom Med sourceExperimental — accuracy not yet measured
In “Impact of Longstanding Type 1 Diabetes” (page unavailable), the paper links white-matter microstructure with a cognitive-test score and reports changes in cortical thickness. The Introduction (page unavailable) reports brain atrophy, while a further passage says the neurochemical findings may indicate neuronal loss or dysfunction. Our copy does not establish the claimed links with microvascular or macrovascular alterations, and neuronal loss is presented as a possibility rather than a demonstrated finding. (LLM, conf=0.85)
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Partly supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“Two examples are the QDiabetes129 and QRISK3130 web calculators that were developed with a prospective general practice dataset of 803 044 people with diabetes (44 440 with type 1 diabetes).”
§ Type 1 diabetes > Complications of type 1 diabetes
What the sources say
- Partly supportedcites [129] Hippisley-Cox, 2015, Development and validation of risk prediction equations to estimate future risk of blindness and lower limb amputation in patients with diabetes: cohort study, BMJ sourceExperimental — accuracy not yet measured
The Results (Overall study population) give 454,575 patients in the derivation cohort and 142,419 and 206,050 in two validation cohorts, totaling 803,044. Table 1 (Baseline characteristics) gives 44,430 patients with type 1 diabetes across those cohorts, not 44,440. The web calculator is documented, but the 803,044 figure includes validation patients rather than only patients used to develop its equations. (LLM, conf=0.90)
- Partly supportedcites [130] Hippisley-Cox, 2017, Development and validation of QRISK3 risk prediction algorithms to estimate future risk of cardiovascular disease: prospective cohort study, BMJ sourceExperimental — accuracy not yet measured
The Methods (Study design and data source) confirm that QRISK3 was developed using prospective general-practice data, and the Discussion (Type 1 diabetes) confirms that it can calculate risk for people with type 1 diabetes. But the Results (Study population) report 7,889,803 people in the derivation cohort, not a cohort of 803,044 people with diabetes; the baseline-characteristics table lists 21,677 with type 1 diabetes in that cohort, not 44,440. This paper does not establish the claim about QDiabetes. (LLM, conf=0.88)
plainn = 803,044- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Partly supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“When insulin was discovered, the University of Toronto freely licensed the right to manufacture the drug;”
§ Type 1 diabetes > Conclusions
What the sources say
- Partly supportedcites [172] Greene, 2015, Why is there no generic insulin? Historical origins of a modern problem, N Engl J Med sourceExperimental — accuracy not yet measured
The “Insulin’s Origins” section says the Toronto team licensed insulin-production rights to numerous companies. It does not say those licences were free of charge, and it places the patent and subsequent licensing after insulin’s 1921 discovery, not at the time of discovery. Our copy provides no page number for this passage. (LLM, conf=0.85)
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Partly supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“yet, people in resource-limited environments continue to die because they have no access to insulin.172”
§ Type 1 diabetes > Conclusions
What the sources say
- Partly supportedcites [172] Greene, 2015, Why is there no generic insulin? Historical origins of a modern problem, N Engl J Med sourceExperimental — accuracy not yet measured
The opening section says insulin is too expensive for many uninsured patients and describes diabetes before insulin as a fatal affliction. It does not report that people currently die because they lack insulin access in resource-limited settings; its discussion of present-day access focuses on North America (The Paradox of Incremental Innovation; page not provided). (LLM, conf=0.84)
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Partly supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“low-dose anti-thymocyte globulin in combination with granulocyte colony-stimulating factor has shown early and sustained efficacy in pilot studies153,154”
§ Type 1 diabetes > Disease-modifying therapies
What the sources say
- Partly supportedcites [153] Haller, 2016, Antithymocyte globulin plus G-CSF combination therapy leads to sustained immunomodulatory and metabolic effects in a subset of responders with established type 1 diabetes, Diabetes sourceExperimental — accuracy not yet measured
The Introduction and Conclusions (page numbers not supplied) report preservation of β-cell function for 12 months with low-dose ATG plus G-CSF. The Conclusions report sustained immunomodulatory effects at 24 months, but the difference in β-cell function versus placebo was no longer statistically significant. Thus, the paper does not establish sustained metabolic efficacy for the pilot cohort as a whole. (LLM, conf=0.89)
- Supportedcites [154] Haller, 2015, Anti-thymocyte globulin/G-CSF treatment preserves β cell function in patients with established type 1 diabetes, J Clin Invest source
The Study design describes a low-dose ATG/G-CSF pilot trial in people with established type 1 diabetes. Table 2 reports better C-peptide preservation than placebo at 6 and 12 months, supporting an early benefit sustained through one year; the Discussion cautions that the 12-month result only approached statistical significance. (LLM, conf=0.85)
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Partly supported
Every source the paper cites for this claim was checked and supports it.
In the paper
“Even if insulin independence is not achieved, severe life-threatening hypoglycaemia can be prevented with minimal islet transplant function.162,163”
§ Type 1 diabetes > Disease-modifying therapies
What the sources say
- Supportedcites [162] Vantyghem, 2012, J Clin Endocrinol Metab source
The Discussion reports that hypoglycemia virtually disappeared when graft function exceeded a β-score of 3, and says current islet-transplant procedures appear sufficient to avoid severe hypoglycemia in most cases. This supports the claim that minimal graft function can provide protection without insulin independence. (LLM, conf=0.91)
- Supportedcites [163] Barton, 2012, Improvement in outcomes of clinical islet transplantation: 1999–2010, Diabetes Care source
The Conclusions state that insulin-dependent islet graft survival, defined by C-peptide >0.3 ng/mL, confers protection from severe hypoglycemia. The paper also says recipients can be protected without achieving insulin independence, provided residual graft function is maintained. (LLM, conf=0.94)
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“several ongoing trials are testing drugs that have successfully targeted β-cell stress responses in mouse models of diabetes.170”
§ Type 1 diabetes > Disease-modifying therapies
What the sources say
- Partly supportedcites [170] Bone, 2017, Combination immunotherapy for type 1 diabetes, Curr Diab Rep sourceExperimental — accuracy not yet measured
The Single immunotherapies section reports that imatinib protected β cells in mouse models and was being tested in a phase II trial. The Concluding Remarks report that imatinib suppresses β-cell ER stress and that a trial of the ER-stress–alleviating drug TUDCA was underway. The paper does not establish that several drugs in ongoing trials had each successfully targeted β-cell stress responses in mouse diabetes models. (LLM, conf=0.85)
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Partly supported
In the paper
“A 2018 meta-analysis of these inhibitors suggests they are safe,87”
§ Type 1 diabetes > Management of clinical disease
What the sources say
- Not checked — no full text of the sourcecites [87] El Masri, 2018, Safety and efficacy of sodium-glucose cotransporter 2 (SGLT2) inhibitors in type 1 diabetes: a systematic review and meta-analysis, Diabetes Res Clin Pract source
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“These increases cannot be explained by genetic changes, implicating environmental or behavioural factors, or both.”
§ Type 1 diabetes > Epidemiology
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“The greatest observed increases in incidence of type 1 diabetes are among children younger than 15 years, particularly in those younger than 5 years.33”
§ Type 1 diabetes > Epidemiology
What the sources say
- Not checked — no full text of the sourcecites [33] Chobot, 2017, Updated 24-year trend of type 1 diabetes incidence in children in Poland reveals a sinusoidal pattern and sustained increase, Diabet Med source
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“Genome-wide association studies have identified over 60 additional non-HLA loci associated with the risk of type 1 diabetes.”
§ Type 1 diabetes > Genetics
What the sources say
- Not checked — no full text of the sourcecites [24] Noble, 2015, Immunogenetics of type 1 diabetes: a comprehensive review, J Autoimmun source
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“When CGM is incorporated into hybrid closed-loop insulin-pump systems that automatically regulate basal infusion rates, but that require manual delivery of meal boluses by trained wearers to cover estimated carbohydrate intakes, substantial improvements in glucose variability and overall glycaemic control are seen (figure 5).93”
§ Type 1 diabetes > Management of clinical disease
What the sources say
- Not checked — no full text of the sourcecites [93] Kovatchev, 2018, The artificial pancreas in 2017: the year of transition from research to clinical practice, Nat Rev Endocrinol source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A claim is checked only against the cited paper’s full text, never its abstract, and none is available for its sources.
In the paper
“The Diabetes Prevention Trial—Type 1, tested whether oral or parental insulin prevented the development of type 1 diabetes in people who were autoantibody positive. Neither approach reduced diabetes development,”
§ Type 1 diabetes > Disease-modifying therapies
What the sources say
- Not checked — no full text of the sourcecites [142] 2002, Effects of insulin in relatives of patients with type 1 diabetes mellitus, N Engl J Med source
- Not checked — no full text of the sourcecites [143] Skyler, 2005, Effects of oral insulin in relatives of patients with type 1 diabetes: the diabetes prevention trial—type 1, Diabetes Care source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“Hypoglycaemia unawareness can improve with edu cation, support, and glucose targets that are aimed at avoiding biochemical hypoglycaemia, while maintaining overall metabolic control.107”
§ Type 1 diabetes > Complications of type 1 diabetes
What the sources say
- Not checked — no full text of the sourcecites [107] Little, 2014, Recovery of hypoglycemia awareness in long-standing type 1 diabetes: a multicenter 2 x 2 factorial randomized controlled trial comparing insulin pump with multiple daily injections and continuous with conventional glucose self-monitoring (HypoCOMPaSS), Diabetes Care source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Despite many attempts at immune intervention, only four categories of drugs have shown efficacy in preserving C-peptide secretion in recent onset type 1 diabetes in randomised placebocontrolled trials.”
§ Type 1 diabetes > Disease-modifying therapies
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“Negative results were also observed in another trial investigating intranasal insulin.145”
§ Type 1 diabetes > Disease-modifying therapies
What the sources say
- Not checked — no full text of the sourcecites [145] Näntö-Salonen, 2008, Nasal insulin to prevent type 1 diabetes in children with HLA genotypes and autoantibodies conferring increased risk of disease: a double-blind, randomised controlled trial, Lancet source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A claim is checked only against the cited paper’s full text, never its abstract, and none is available for its sources.
In the paper
“but subgroup analyses suggested a benefit of oral insulin in individuals with the highest titres of insulin auto-antibodies.142,143”
§ Type 1 diabetes > Disease-modifying therapies
What the sources say
- Not checked — no full text of the sourcecites [142] 2002, Effects of insulin in relatives of patients with type 1 diabetes mellitus, N Engl J Med source
- Not checked — no full text of the sourcecites [143] Skyler, 2005, Effects of oral insulin in relatives of patients with type 1 diabetes: the diabetes prevention trial—type 1, Diabetes Care source
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“Type 1 diabetes during puberty also appears to accelerate the development of complications.117”
§ Type 1 diabetes > Complications of type 1 diabetes
What the sources say
- Not checked — no full text of the sourcecites [117] Cho, 2014, Puberty as an accelerator for diabetes complications, Pediatr Diabetes source
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A claim is checked only against the cited paper’s full text, never its abstract, and none is available for its sources.
In the paper
“Hypoglycaemic events are associated with adverse effects on cognitive function,108,109”
§ Type 1 diabetes > Complications of type 1 diabetes
What the sources say
- Not checked — no full text of the sourcecites [108] Cameron, 2015, Care of diabetes in children and adolescents: controversies, changes, and consensus, Lancet source
- Not checked — no full text of the sourcecites [109] 2007, Long-term effect of diabetes and its treatment on cognitive function, N Engl J Med source
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A claim is checked only against the cited paper’s full text, never its abstract, and none is available for its sources.
In the paper
“Variability in glucose concentrations (both during the day and longer term) and glycosylation rates also probably have a role in interindividual differences.115,116”
§ Type 1 diabetes > Complications of type 1 diabetes
What the sources say
- Not checked — no full text of the sourcecites [115] Bergenstal, 2015, Glycemic variability and diabetes complications: does it matter? Simply put, there are better glycemic markers!, Diabetes Care source
- Not checked — no full text of the sourcecites [116] Virk, 2016, Association between HbA1c variability and risk of microvascular complications in adolescents with type 1 diabetes, J Clin Endocrinol Metab source
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“the first definitive evidence linking glycaemic control with complication status in 1993.81”
§ Type 1 diabetes > Conclusions
What the sources say
- Not checked — no full text of the sourcecites [81] 1993, The effect of intensive treatment of diabetes on the development and progression of long-term complications in insulin-dependent diabetes mellitus, N Engl J Med source
boostedcorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Although the phase 2 trials of these drugs met their primary or secondary endpoints, defined as an improvement in the C-peptide area-under-the-curve response during a mixed meal tolerance test,”
§ Type 1 diabetes > Disease-modifying therapies
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“Shapiro and colleagues’ landmark work, by use of a steroid free Edmonton Protocol,160 showed that islet transplantation could achieve insulin independence”
§ Type 1 diabetes > Disease-modifying therapies
What the sources say
- Not checked — no full text of the sourcecites [160] Shapiro, 2000, Islet transplantation in seven patients with type 1 diabetes mellitus using a glucocorticoid-free immunosuppressive regimen, N Engl J Med source
hedgeddirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Probably not a substantial claim. 13
- It may state two separate claims as one. 18
Some cited sources support this claim and some don’t — read each source’s verdict below.
In the paper
“Severe hypoglycaemic events requiring treatment assistance from another person occur at rates of 16–20 per 100 person-years;”
§ Type 1 diabetes > Complications of type 1 diabetes
What the sources say
- Disputedcites [103] Cengiz, 2013, Severe hypoglycemia and diabetic ketoacidosis among youth with type 1 diabetes in the T1D exchange clinic registry, Pediatr Diabetes sourceExperimental — accuracy not yet measured
The Results (Severe Hypoglycemia; page unavailable) report that 6.2% of participants had at least one event in 12 months, not a rate of 16–20 events per 100 person-years. The Discussion explicitly says the study counted events involving seizure or loss of consciousness, rather than events merely requiring another person's assistance, and did not report an event rate. (LLM, conf=0.88)
Checked by a reasoning model — may be wrong.
- Partly supportedcites [104] O'Connell, 2011, Reducing rates of severe hypoglycemia in a population-based cohort of children and adolescents with type 1 diabetes over the decade 2000–2009, Diabetes Care sourceExperimental — accuracy not yet measured
The Abstract Results report a peak of 17.3 severe hypoglycemia events per 100 patient-years in 2001, within the claimed range, but a decline to 5.8 by 2006; they do not support 16–20 as a general rate. The Research Design and Methods section defines an event as one causing loss of consciousness or seizure, not one requiring assistance from another person. (LLM, conf=0.88)
- Not checked — no full text of the sourcecites [105] Karges, 2015, Hospital admission for diabetic ketoacidosis or severe hypoglycemia in 31,330 young patients with type 1 diabetes, Eur J Endocrinol source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
- Disputed
Every source the paper cites for this claim was checked and supports it.
In the paper
“the disease can occur at any age, with up to 50% of cases occurring in adulthood.7”
- Also stated in: § Diagnosis · plain
“Although traditional definitions classified type 1 diabetes as juvenile onset, the disease can occur at any age, with up to 50% of cases occurring in adulthood.7”
§ Type 1 diabetes > Diagnosis
What the sources say
- Supportedcites [7] Thomas, 2018, Frequency and phenotype of type 1 diabetes in the first six decades of life: a cross-sectional, genetically stratified survival analysis from UK Biobank, Lancet Diabetes Endocrinol source
The Introduction says type 1 diabetes can occur at any age. The Results report that 42% of genetically defined cases in the UK Biobank sample were diagnosed at ages 31–60, supporting the claim that up to 50% occur in adulthood within the study’s first-six-decades scope. (LLM, conf=0.92)
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Also stated in: § Diagnosis · plain
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“Although insulitis is common and intense in animal models of type 1 diabetes, it is much rarer and more variable in human beings (figure 3).60”
§ Type 1 diabetes > The immune phenotype of type 1 diabetes
What the sources say
- Partly supportedcites [60] Campbell-Thompson, 2015, Organ donor specimens: what can they tell us about type 1 diabetes?, Pediatr Diabetes sourceExperimental — accuracy not yet measured
The section “Insulitis in the natural history of T1D” (page not provided) reports low proportions of affected islets in human donors and describes variation within and between donors. It does not establish that insulitis is common and intense in animal models, so the comparison is only partly supported. (LLM, conf=0.86)
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Partly supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“Globally, type 1 diabetes is increasing both in incidence and prevalence, with overall annual increases in incidence of about 2–3% per year.29,30”
§ Type 1 diabetes > Epidemiology
What the sources say
- Partly supportedcites [29] Maahs, 2010, Epidemiology of type 1 diabetes, Endocrinol Metab Clin North Am sourceExperimental — accuracy not yet measured
The Incidence: Temporal Trends section reports a 2.8% average annual increase in type 1 diabetes incidence across studied populations in 57 countries, supporting the approximate 2–3% figure. That estimate concerns children aged 14 or younger, and the cited passages do not establish a global increase in prevalence. (LLM, conf=0.85)
- Partly supportedcites [30] Mayer-Davis, 2017, Incidence trends of type 1 and type 2 diabetes among youths, 2002–2012, N Engl J Med sourceExperimental — accuracy not yet measured
The Introduction reports that type 1 diabetes incidence has increased worldwide, and the Discussion notes increased prevalence among U.S. youths. The Results report a 1.8% adjusted annual increase in incidence among U.S. youths, not a global increase of 2–3% per year; the paper does not establish a global prevalence trend. (LLM, conf=0.87)
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
- Partly supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“Children with type 1 diabetes commonly present with symptoms of polyuria, polydipsia, and weight loss; approximately a third present with diabetic ketoacidosis.6”
§ Type 1 diabetes > Diagnosis
What the sources say
- Partly supportedcites [6] Dabelea, 2014, Trends in the prevalence of ketoacidosis at diabetes diagnosis: the SEARCH for diabetes in youth study, Pediatrics sourceExperimental — accuracy not yet measured
The Abstract and Discussion (page unavailable in our copy) report that almost one-third of youth with type 1 diabetes present with DKA. The paper refers generally to signs and symptoms of diabetes, but does not identify polyuria, polydipsia, and weight loss as common presenting symptoms. (LLM, conf=0.90)
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Partly supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“Although survival and patient health have improved considerably, particularly in the past 25 years, a cure for type 1 diabetes remains elusive.1,2”
§ Type 1 diabetes > Introduction
What the sources say
- Not checked — no full text of the sourcecites [1] Barnett, 2018, Type 1 diabetes, Lancet source
- Partly supportedcites [2] Skyler, 2018, Hope vs hype: where are we in type 1 diabetes?, Diabetologia sourceExperimental — accuracy not yet measured
The Pancreas transplantation section (page unavailable) reports better 10-year survival for patients receiving a combined pancreas–kidney transplant than for those receiving a kidney transplant alone, and describes improving transplant outcomes. It does not establish that survival and health improved considerably for people with type 1 diabetes generally, particularly over the past 25 years. (LLM, conf=0.82)
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“and accounts for 13–19% of type 1 diabetes-related mortality.105,110,111”
§ Type 1 diabetes > Complications of type 1 diabetes
What the sources say
- Partly supportedcites [110] Feltbower, 2008, Acute complications and drug misuse are important causes of death for children and young adults with type 1 diabetes: results from the Yorkshire Register of diabetes in children and young adults, Diabetes Care sourceExperimental — accuracy not yet measured
The Results report 14 deaths from diabetic ketoacidosis, and Table 3 reports 108 deaths from all causes—about 13%. This supports the lower end of the cited range in this Yorkshire cohort, but the paper does not establish the 19% figure or the full range. (LLM, conf=0.87)
- Partly supportedcites [111] Patterson, 2007, Early mortality in EURODIAB population-based cohorts of type 1 diabetes diagnosed in childhood since 1989, Diabetologia sourceExperimental — accuracy not yet measured
The Results (page unavailable) report diabetic ketoacidosis mentioned in 27 of 141 deaths among people with type 1 diabetes, approximately 19%. But only 47 deaths were classified as directly attributable to diabetes; ketoacidosis was mentioned in 27 of those, approximately 57%. The paper therefore supports the 19% figure only for all deaths in the cohort, not a 13–19% range for deaths attributable to diabetes. (LLM, conf=0.86)
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
- Partly supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“and are associated with 4–10% of type 1 diabetes-related deaths.110–112”
§ Type 1 diabetes > Complications of type 1 diabetes
What the sources say
- Supportedcites [110] Feltbower, 2008, Acute complications and drug misuse are important causes of death for children and young adults with type 1 diabetes: results from the Yorkshire Register of diabetes in children and young adults, Diabetes Care source
The Results report 8 deaths from hypoglycaemia among 108 deaths in the Yorkshire cohort of children and young adults with type 1 diabetes. That is about 7.4% of all deaths in the cohort, within the cited 4–10% range. (LLM, conf=0.88)
- Partly supportedcites [111] Patterson, 2007, Early mortality in EURODIAB population-based cohorts of type 1 diabetes diagnosed in childhood since 1989, Diabetologia sourceExperimental — accuracy not yet measured
The Results report five deaths directly ascribed to hypoglycaemia among 47 deaths assessed as directly attributable to diabetes—about 11% in this childhood-onset European cohort. The paper does not report a 4–10% range for diabetes-related deaths or establish that range beyond this cohort. (LLM, conf=0.83)
- Partly supportedcites [112] Skrivarhaug, 2006, Long-term mortality in a nationwide cohort of childhood-onset type 1 diabetic patients in Norway, Diabetologia sourceExperimental — accuracy not yet measured
The clinical-review results report 11 deaths classified as due to hypoglycaemia among 103 deaths—about 11%—in a Norwegian cohort with childhood-onset type 1 diabetes. This supports an association with deaths, but the paper does not establish the stated 4–10% range for type 1 diabetes-related deaths generally. (LLM, conf=0.84)
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
- Supported
The sources with a verdict support this claim; the rest weren’t checked yet, have no full text we could read, or their verdicts aren’t rated yet.
In the paper
“Guidelines from the American Diabetes Association, International Society for Pediatric and Adolescent Diabetes, and Candian Diabetes Association suggest a HbA1c target of less than 53 mmol/mol (7·0%) for adults and less than 58 mmol/mol (7·5%) in paediatric patients with type 1 diabetes;94–96”
§ Type 1 diabetes > Management of clinical disease
What the sources say
- Not checked yetcites [94] 2018, 6. Glycemic targets: standards of medical care in diabetes-2018, Diabetes Care
- Supportedcites [95] Rewers, 2014, ISPAD clinical practice concensus guidelines 2014. Assessment and monitoring of glycemic control in children and adolescents with diabetes, Pediatric Diabetes source
The HbA1c targets section recommends <7.5% (58 mmol/mol) for all patients younger than 18 and says the American Diabetes Association adopted the same pediatric target. The Rewers et al. section identifies <7% as the adult target. This paper supports the guideline targets it is cited for; the other citations in the sentence need not be established by this source. (LLM, conf=0.88)
- Not checked yetcites [96] 2013, Canadian Diabetes Association 2013 clinical practice guidelines for the prevention and management of diabetes in Canada. Introduction, Can J Diabetes
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“hypoglycaemic events leading to loss of consciousness or seizure occur at a rate of 2–8 per 100 person-years.103–105”
§ Type 1 diabetes > Complications of type 1 diabetes
What the sources say
- Partly supportedcites [103] Cengiz, 2013, Severe hypoglycemia and diabetic ketoacidosis among youth with type 1 diabetes in the T1D exchange clinic registry, Pediatr Diabetes sourceExperimental — accuracy not yet measured
The Results (Severe Hypoglycemia; page unavailable) report that 6.2% of participants had at least one event involving seizure or loss of consciousness within 12 months. The Discussion explicitly distinguishes that percentage of participants from a rate measured as events per 100 person-years. The source therefore supports the event type and a broadly similar annual frequency, but not the claimed rate of 2–8 events per 100 person-years. (LLM, conf=0.88)
- Partly supportedcites [104] O'Connell, 2011, Reducing rates of severe hypoglycemia in a population-based cohort of children and adolescents with type 1 diabetes over the decade 2000–2009, Diabetes Care sourceExperimental — accuracy not yet measured
The Research Design and Methods section defines these events as hypoglycemia leading to loss of consciousness or seizure. The reported rate reached 5.8 per 100 patient-years, within the claimed range, but peaked at 17.3; the paper therefore does not support 2–8 as the range for its cohort of children with type 1 diabetes (Abstract, Results; page unavailable). (LLM, conf=0.88)
- Not checked — no full text of the sourcecites [105] Karges, 2015, Hospital admission for diabetic ketoacidosis or severe hypoglycemia in 31,330 young patients with type 1 diabetes, Eur J Endocrinol source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
- Partly supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“Cardiovascular disease remains the major cause of premature morbidity and mortality, with data119,120 suggesting an 8–13-year shorter life expectancy for people with type 1 diabetes than for healthy individuals.”
§ Type 1 diabetes > Complications of type 1 diabetes
What the sources say
- Not checked — no full text of the sourcecites [119] Huo, 2016, Burden of diabetes in Australia: life expectancy and disability-free life expectancy in adults with diabetes, Diabetologia source
- Partly supportedcites [120] Livingstone, 2015, Estimated life expectancy in a Scottish cohort with type 1 diabetes, 2008-2010, JAMA sourceExperimental — accuracy not yet measured
The Results (Deaths by Cause; Examination of the Life Expectancy Differential by Age and Cause) identify ischemic heart disease as the most commonly reported cause of death and circulatory disease as the largest contributor to lost life expectancy. The Abstract (Results) reports losses of about 8 years in a preserved-kidney-function subgroup and 11–13 years overall. The paper does not establish cardiovascular disease as a leading cause of morbidity, and its comparator is the general population without type 1 diabetes, not specifically healthy individuals. (LLM, conf=0.87)
hedgeddirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“In the past 25 years, among people with type 1 diabetes the risks of microvascular and macrovascular compli-cations have substantially decreased and outcomes have improved.125,126”
§ Type 1 diabetes > Complications of type 1 diabetes
What the sources say
- Partly supportedcites [125] Lachin, 2014, Update on cardiovascular outcomes at 30 years of the diabetes control and complications trial/epidemiology of diabetes interventions and complications study, Diabetes Care sourceExperimental — accuracy not yet measured
The Introduction and Conclusions (page not specified) report substantial long-term benefits of intensive treatment for both microvascular disease and cardiovascular outcomes in the DCCT/EDIC participants with type 1 diabetes. They do not establish that complication risks declined over the past 25 years among people with type 1 diabetes generally; the comparison is intensive versus conventional treatment, not a population-wide trend over time. (LLM, conf=0.86)
- Partly supportedcites [126] Fullerton, 2014, Intensive glucose control versus conventional glucose control for type 1 diabetes mellitus, Cochrane Database Syst Rev sourceExperimental — accuracy not yet measured
The review’s ‘Why it is important to do this review’ section says that treatment advances have made prospects for people with type 1 diabetes much better than in the past. Its Authors’ conclusions report reduced microvascular complications with tight glucose control, and ‘Agreements and disagreements with other studies or reviews’ reports a cardiovascular benefit in a follow-up study. It does not establish that both microvascular and macrovascular complication risks substantially declined across the type 1 diabetes population over the past 25 years; the latter section says its own meta-analysis cannot assess major macrovascular outcomes. (LLM, conf=0.86)
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Partly supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“Pancreas transplants have been performed for over 50 years and have become a standard-of-care treatment in individuals who have developed end-stage renal failure and require kidney transplantation.158”
§ Type 1 diabetes > Disease-modifying therapies
What the sources say
- Partly supportedcites [158] Lindahl, 2013, Improved patient survival with simultaneous pancreas and kidney transplantation in recipients with diabetic end-stage renal disease, Diabetologia sourceExperimental — accuracy not yet measured
The Introduction dates the first pancreas transplant to 1966, consistent with a history of more than 50 years by the time of the citing statement. It calls transplantation an effective option especially for patients with diabetes and end-stage renal disease, but does not establish it as standard care for everyone with end-stage renal failure who needs a kidney transplant; it describes eligibility limits and kidney-only alternatives. (LLM, conf=0.87)
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Partly supported
Every source the paper cites for this claim was checked and supports it.
In the paper
“Moreover, morbidity associated with immunosuppression and limitations in the supply of donor islets restricts the number of people who can benefit from islet transplantation.161”
§ Type 1 diabetes > Disease-modifying therapies
What the sources say
- Supportedcites [161] Shapiro, 2006, International trial of the Edmonton protocol for islet transplantation, N Engl J Med source
The Discussion (p. 11) reports immunosuppression-related side effects that required therapy changes and sometimes withdrawal from the trial. The Discussion (p. 12) also states that the supply of islets from deceased donors cannot meet demand. Together, these support the claim that both factors limit who can benefit. (LLM, conf=0.94)
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Supported
The sources with a verdict support this claim; the rest weren’t checked yet, have no full text we could read, or their verdicts aren’t rated yet.
In the paper
“Other novel approaches include autologous haemopoietic stem-cell transplantation165,166 and autologous T-regulatory cell administration.167–169”
§ Type 1 diabetes > Disease-modifying therapies
What the sources say
- Not checked — no full text of the sourcecites [165] Cantú-Rodríguez, 2016, Long-term insulin independence in type 1 diabetes mellitus using a simplified autologous stem cell transplant, J Clin Endocrinol Metab source
- Supportedcites [166] Couri, 2009, C-peptide levels and insulin independence following autologous nonmyeloablative hematopoietic stem cell transplantation in newly diagnosed type 1 diabetes mellitus, JAMA source
The citation is attached to autologous haemopoietic stem-cell transplantation, not T-regulatory cell administration. The Stem Cell Mobilization Regimen and Conditioning Regimen sections describe harvesting the patients’ own stem cells and infusing them after conditioning, so this paper is an example of the cited approach. (LLM, conf=0.94)
- Supportedcites [167] Bluestone, 2015, Type 1 diabetes immunotherapy using polyclonal regulatory T cells, Sci Transl Med source
The citation is attached to autologous T-regulatory cell administration, not stem-cell transplantation. The Introduction describes a phase 1 trial in which patients with recent-onset type 1 diabetes received an infusion of expanded regulatory T cells, and the Discussion identifies these as autologous Tregs derived from patients with type 1 diabetes. (LLM, conf=0.93)
- Not checked — no full text of the sourcecites [168] Marek-Trzonkowska, 2014, Therapy of type 1 diabetes with CD4(+)CD25(high)CD127-regulatory T cells prolongs survival of pancreatic islets—results of one year follow-up, Clin Immunol source
- Supportedcites [169] Marek-Trzonkowska, 2012, Administration of CD4+CD25highCD127-regulatory T cells preserves β-cell function in type 1 diabetes in children, Diabetes Care source
The citation range attached to this source concerns autologous T-regulatory cell administration, not stem-cell transplantation. The Research Design and Methods passage reports infusion of expanded autologous Tregs into children with type 1 diabetes, and the Conclusions describe it as a novel approach. (LLM, conf=0.94)
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A claim is checked only against the cited paper’s full text, never its abstract, and none is available for its sources.
In the paper
“Type 1 diabetes is a heritable polygenic disease with identical twin concordance of 30–70%,20 sibling risk of 6–7%, and a risk of 1–9% for children who have a parent with diabetes.21”
§ Type 1 diabetes > Genetics
What the sources say
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“However, wide gaps still exist in our understanding of type 1 diabetes and our ability to standardise clinical care and decrease disease-associated complications and burden.”
§ Type 1 diabetes > Abstract
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Knowledge of type 1 diabetes has rapidly increased over the past 25 years, resulting in a broad understanding about many aspects of the disease, including its genetics, epidemiology, immune and β-cell phenotypes, and disease burden.”
§ Type 1 diabetes > Abstract
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. The paper may give no reason why it holds.
In the paper
“Two HLA class 2 haplotypes involved in anti gen presentation, HLA DRB1*0301-DQA1*0501-DQ*B10201 (DR3) and HLA DRB1*0401-DQA1*0301-DQB1*0301 (DR4-DQ8), are linked to approximately 50% of disease heritability and are prevalent in white people.24”
§ Type 1 diabetes > Genetics
What the sources say
- Not checked — no full text of the sourcecites [24] Noble, 2015, Immunogenetics of type 1 diabetes: a comprehensive review, J Autoimmun source
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“However, since dysglycaemia progression can be rapid in patients with type 1 diabetes, HbA1c is less sensitive for diagnosis than fasting or stimulated blood glucose measurements.5”
§ Type 1 diabetes > Diagnosis
What the sources say
- Not checked yetcites [5] 2018, 2. Classification and diagnosis of diabetes: standards of medical care in diabetes-2018, Diabetes Care
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“Increased frequency of islet-specific autoreactive CD8+ T lymphocytes and decreased regulatory immune function have been associated with type 1 diabetes.50”
§ Type 1 diabetes > The immune phenotype of type 1 diabetes
What the sources say
- Not checked — no full text of the sourcecites [50] Roep, 1990, T-cell clones from a type-1 diabetes patient respond to insulin secretory granule proteins, Nature source
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“What once seemed like a single autoimmune disorder, with roots in T-cell mediated attack of insulin-producing β cells, is now recognised to result from a complex interplay between environmental factors and microbiome, genome, metabolism, and immune systems that vary between individual cases.”
§ Type 1 diabetes > Introduction
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“Guidelines for the care of people with diabetes include periodic screening for these diseases, particularly thyroid and coeliac diseases.102”
§ Type 1 diabetes > Management of clinical disease
What the sources say
- Not checked yetcites [102] 2018, 3. Comprehensive medical evaluation and assessment of comorbidities: standards of medical care in diabetes-2018, Diabetes Care
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“Treatment in hospital for diabetic ketoacidosis occurs at a rate of 1–10 per 100 patient-years in paediatric populations with established type 1 diabetes,”
§ Type 1 diabetes > Complications of type 1 diabetes
What the sources say
- Not checked — no full text of the sourcecites [105] Karges, 2015, Hospital admission for diabetic ketoacidosis or severe hypoglycemia in 31,330 young patients with type 1 diabetes, Eur J Endocrinol source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
A claim is checked only against the cited paper’s full text, never its abstract, and none is available for its sources.
In the paper
“Although ciclosporin was unable to induce a durable disease remission, insulin requirements of patients decreased during active treatment, generating enthusiasm that immune modulation could treat type 1 diabetes.134–136”
§ Type 1 diabetes > Disease-modifying therapies
What the sources say
- Not checked — no full text of the sourcecites [134] 1988, Cyclosporin-induced remission of IDDM after early intervention: association of 1 yr of cyclosporin treatment with enhanced insulin secretion, Diabetes source
- Not checked — no full text of the sourcecites [135] De Filippo, 1996, Long-term results of early cyclosporin therapy in juvenile IDDM, Diabetes source
- Not checked — no full text of the sourcecites [136] Feutren, 1986, Cyclosporin increases the rate and length of remissions in insulin-dependent diabetes of recent onset. Results of a multicentre double-blind trial, Lancet source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“women with type 1 diabetes have been shown to have higher rates of all-cause premature mortality and vascular events than do men with type 1 diabetes.128”
§ Type 1 diabetes > Complications of type 1 diabetes
What the sources say
- Not checked — no full text of the sourcecites [128] Huxley, 2015, Risk of all-cause mortality and vascular events in women versus men with type 1 diabetes: a systematic review and meta-analysis, Lancet Diabetes Endocrinol source
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“Simultaneous kidney and pancreas transplantation in experienced centres can offer an up to 80% chance of insulin independence for over 5 years, but there is substantial surgical risk, and the requirement of immunosuppression.159”
§ Type 1 diabetes > Disease-modifying therapies
What the sources say
- Not checked — no full text of the sourcecites [159] Gruessner, 2013, The current state of pancreas transplantation, Nat Rev Endocrinol source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“no drug has yet been able to induce insulin independence or progressed to a positive phase 3 trial that was translatable into clinical care.”
§ Type 1 diabetes > Disease-modifying therapies
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
The paper relies on this without support.
Most people diagnosed with type 1 diabetes do not have a relative with the disease or the highest risk combination of HLA alleles.
“Despite known genetic underpinnings, most people who are diagnosed with type 1 diabetes do not have a relative with the disease or even the highest risk combination of HLA alleles, making attempts at primary disease prevention difficult.”
The paper relies on this without support.
Glycaemic control for most people with type 1 diabetes is not optimised.
“Additionally, despite advances in technology, glycaemic control for most people with type 1 diabetes is not optimised”
The paper relies on this without support.
Many people with type 1 diabetes cannot access modern therapies because of the high costs of even basic care.
“and many cannot access modern therapies because of the high costs of even basic care.”
The paper relies on this without support.
Over time, many residual β cells are lost.
“Over time, many of these residual cells are lost.”
The paper relies on this without support.
Insulin remains the mainstay of therapy for type 1 diabetes.
“Although insulin remains the mainstay of therapy, new insulin analogues with varying onsets and durations of action are widely available.”
The paper relies on this without support.
Type 1 diabetes continues to impose substantial medical, psychological, and financial burden.
“the disease continues to be associated with substantial medical, psychological, and financial burden.”
The paper relies on this without support.
Hyperglycaemia is the primary risk factor for microvascular disease.
“Hyperglycaemia is the primary risk factor for microvascular disease”
The paper relies on this without support.
Reducing HbA1c through intensive diabetes management, particularly early in disease, is associated with about 70% reductions in incidence and slower progression of microvascular disease.
“reducing HbA1c through intensive diabetes management, particularly early during disease, is associated with striking (about 70%) reductions in incidence and slower progression of microvascular disease.”
The paper relies on this without support.
Differences in HbA1c do not fully explain variation in incidence and severity of complications between individuals.
“However, differences in HbA1c do not fully explain the variation in the incidence of complications and the severity of disease between individuals.”
The paper relies on this without support.
The risk of cardiovascular complications does not appear to be as attenuated by intensive blood sugar control as microvascular complications.
“By contrast with microvascular complications, the risk of cardiovascular complications does not appear to be as attenuated by intensive blood sugar control.”
The paper relies on this without support.
For over 30 years, most efforts to cure type 1 diabetes have focused on altering the immune system's attack on β cells.
“For over 30 years, most efforts to cure type 1 diabetes have focused on altering the immune system’s attack on β cells.”
The paper relies on this without support.
Islet transplantation is a low-risk procedure.
“Islet transplantation is a low-risk procedure, with donor islets infused into the liver via the portal vein.”
The paper relies on this without support.
Only a minority of islet transplant recipients achieve durable insulin independence.
“However, only a minority of islet transplant recipients achieve durable insulin independence.”
The paper relies on this without support.
Currently, islet transplantation is used in a small subset of patients with extremely severe hypoglycaemic unawareness.
“Currently, islet transplantation is used in a small subset of patients who have extremely severe hypoglycaemic unawareness.”
Citations
Cites
(1993) · New England Journal of Medicine · doi:10.1056/nejm199309303291401 · Cited by 24,667
Shapiro, A. M. J., Lakey, J. R. T., Ryan, E. A., Korbutt, G. S., Toth, E., Warnock, G. L., Kneteman, N. M., & Rajotte, R. V. (2000) · New England Journal of Medicine · doi:10.1056/nejm200007273430401 · Cited by 5,237
2. Classification and Diagnosis of Diabetes: Standards of Medical Care in Diabetes—2022
American Diabetes Association Professional Practice Committee (2022) · Diabetes Care · doi:10.2337/dc22-s002 · Cited by 4,792
2. Classification and Diagnosis of Diabetes: Standards of Medical Care in Diabetes—2018
American Diabetes Association (2018) · Diabetes Care · doi:10.2337/dc18-s002 · Cited by 3,159
Inzucchi, S. E., Bergenstal, R. M., Buse, J. B., Diamant, M., Ferrannini, E., Nauck, M., Peters, A. L., Tsapas, A., Wender, R., & Matthews, D. R. (2015) · Diabetes Care · doi:10.2337/dc14-2441 · Cited by 3,066
Atkinson, M. A., Eisenbarth, G. S., & Michels, A. W. (2014) · The Lancet · doi:10.1016/s0140-6736(13)60591-7 · Cited by 2,931
International trial of the Edmonton protocol for islet transplantation
Shapiro, A. M. J., Ricordi, C., Hering, B. J., Auchincloss, H., Lindblad, R., Robertson, R. P., Secchi, A., Brendel, M. D., Berney, T., Brennan, D. C., et al. (2006) · New England Journal of Medicine · doi:10.1056/nejmoa061267 · Cited by 1,942
Nathan, D. M., & for the DCCT/EDIC Research Group (2014) · Diabetes Care · doi:10.2337/dc13-2112 · Cited by 1,832
Hippisley-Cox, J., Coupland, C., & Brindle, P. (2017) · BMJ · doi:10.1136/bmj.j2099 · Cited by 1,703
Incidence trends of type 1 and type 2 diabetes among youths, 2002–2012
Mayer-Davis, E. J., Lawrence, J. M., Dabelea, D., Divers, J., Isom, S., Dolan, L., Imperatore, G., Linder, B., Marcovina, S., Pettitt, D. J., et al. (2017) · New England Journal of Medicine · doi:10.1056/nejmoa1610187 · Cited by 1,476
Research works printed but not linked: 2
- Eisenbarth, 1984, Autoimmune beta cell insufficiency—diabetes mellitus type 1, Triangle, 23, 111
- Thomas, 2016, Classifying diabetes by type 1 genetic risk shows autoimmune diabetes cases are evenly distributed above and below 30 years of age, Diabetologia, 59, S135
Cited by
Sorted by citations
Nalbandian, A., Sehgal, K., Gupta, A., Madhavan, M. V., McGroder, C., Stevens, J. S., Cook, J. R., Nordvig, A. S., Shalev, D., Sehrawat, T. S., et al. (2021) · Nature Medicine · doi:10.1038/s41591-021-01283-z · Cited by 4,862
Pancreatic β-cells in type 1 and type 2 diabetes mellitus: different pathways to failure
Eizirik, D. L., Pasquali, L., & Cnop, M. (2020) · Nature Reviews Endocrinology · doi:10.1038/s41574-020-0355-7 · Cited by 854
Neutrophils in chronic inflammatory diseases
Herrero-Cervera, A., Soehnlein, O., & Kenne, E. M. (2022) · Cellular and Molecular Immunology · doi:10.1038/s41423-021-00832-3 · Cited by 749
Lu, Y. P., Zhou, G., Ewald, J., Pang, Z., Shiri, T. J., & Xia, J. (2023) · Nucleic Acids Research · doi:10.1093/nar/gkad407 · Cited by 668
Schalkwijk, C., & Stehouwer, C. D. A. (2019) · Physiological Reviews · doi:10.1152/physrev.00001.2019 · Cited by 649
Metadata
- Authors
- DiMeglio, L. A., Evans-Molina, C., & Oram, R. A.
- Affiliations
- Indiana University School of Medicine (US)
- University of Exeter (GB)
- Corresponding author
- DiMeglio, Linda A
- Venue
- The Lancet
- Publisher
- Elsevier BV
- Published
- 2018-06
- Volume
- 391
- Issue
- 10138
- Pages
- 2449-2462
- ISSN
- 0099-5355 (ISSN-L)
- 0140-6736
- PMC
- PMC6661119
- OpenAlex
- W2807893746
- Cited by
- 1,561
- References
- 179
- Citations by year
- 2026: 125 · 2025: 246 · 2024: 261 · 2023: 305 · 2022: 276 · 2021: 174 · 2020: 97 · 2019: 60 · 2018: 12
- FWCI
- 11.89
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- The Lancet (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- IUScholarWorks (Indiana University) (submittedVersion)
- Purdue University Indianapolis (Indiana University) (submittedVersion)
- Funders
- U.S. Department of Veterans Affairs (I01-BX001733)
- Medical Research Council (MC_PC_15047)
- National Institute of Diabetes and Digestive and Kidney Diseases (R01DK093954)
- Topics
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Diabetes and associated disorders
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
- Keywords
- type 1 diabetes, autoimmune disease, insulin deficiency, hyperglycemia, beta-cell preservation, disease burden, disease complications, clinical management, immunophenotype
- MeSH terms
- B-Lymphocytes, Blood Glucose, Diabetes Mellitus, Type 1, Haplotypes, Glycated Hemoglobin, Humans, Hypoglycemic Agents, Phenotype, Blood Glucose Self-Monitoring
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
A language model drew the claims from the paper on 2026-09-28, under version 3 of the claim definition (prompt extract-v3).
A second model labelled each claim on 2026-09-28 (model jev-1.13-20260917, definition revision gold-guideline-v0.2).
Cited sources are checked with a language model’s help (gpt-6-sol).
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
