The presymptomatic phase of type 1 diabetes is marked by the presence of two or more islet autoantibodies, classified into normoglycaemia (stage 1) and dysglycaemia (stage 2).1–3 These stages guide the indication of therapies such as the anti-CD3 antibody, teplizumab, which is FDA approved for children aged 8 years or older with stage 2 type 1 diabetes. In the past decade, criteria for stage 2 have changed. TrialNet showed efficacy of teplizumab over placebo in delaying the clinical onset of type 1 diabetes and initially required two assessments that confirmed dysglycaemia, which was defined by impaired glucose tolerance (7·8–11·0 mmol/L at 120 min on an oral glucose tolerance test [OGTT]); impaired 30, 60, or 90 min OGTT values (≥11·1 mmol/L); or impaired fasting glucose (6·1–6·9 mmol/L) and was later modified to one assessment for people younger than 18 years.