The relevance of further sub-classifying type 1 diabetes may appear less immediately apparent than for type 2. After all, once total beta-cell destruction has occurred then insulin replacement therapy will have to be used irrespective of the cause. However, certain genetic sub-types may be at much higher risk of other autoimmune diseases or complications, for example, and the identification of these at an early stage would be highly relevant. The real importance of sub-phenotyping in type 1 diabetes will be in the research effort to identify at risk and presymptomatic individuals and to intervene in their autoimmune process using therapies that are directed at their particular disease processes. This is still a long way off, but vigorous efforts are underway18.
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