Heinrich M, et al. - In children with presymptomatic type 1 diabetes, researchers examined the prevalence of hypoglycemia and its relationship with disease progression. For this investigation, they compared the frequency of hypoglycemic fasting blood glucose levels (< 60 mg/dl) in 48 autoantibody negative and 167 multiple beta-cell autoantibody positive children aged 2-5 years. It was noted that children who had hypoglycemic vs normoglycemic fasting blood glucose values had higher 120-minute blood glucose values under oral glucose tolerance tests (OGTT) challenge, and a higher rate of pathological OGTTs. Results of this study suggested that, in presymptomatic type 1 diabetes, fasting hypoglycemia appears to indicate disease progression. This represents a novel marker for the identifying children who should be more closely monitored for progression towards insulin dependent type 1 diabetes.