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Diabetes Care. 2011 Jun;34(6):1397-9. doi: 10.2337/dc10-2088. Epub 2011 May 11.

Age of islet autoantibody appearance and mean levels of insulin, but not GAD or IA-2 autoantibodies, predict age of diagnosis of type 1 diabetes: diabetes autoimmunity study in the young.

Author information

  • 1Barbara Davis Center for Childhood Diabetes, University of Colorado Denver, Aurora, Colorado, USA. andrea.steck@ucdenver.edu

Abstract

OBJECTIVE:

We evaluated predictors of progression to diabetes in children with high-risk HLA genotypes and persistent islet autoantibodies.

RESEARCH DESIGN AND METHODS:

The Diabetes Autoimmunity Study in the Young (DAISY) followed 2,542 children with autoantibodies measured to GAD, IA-2, and insulin.

RESULTS:

Persistent islet autoantibodies developed in 169 subjects, and 55 of those progressed to diabetes. Children expressing three autoantibodies showed a linear progression to diabetes with 74% cumulative incidence by the 10-year follow-up compared with 70% with two antibodies and 15% with one antibody (P < 0.0001). Both age of appearance of first autoantibody and insulin autoantibody (IAA) levels, but not GAD or IA-2 autoantibodies, were major determinants of the age of diabetes diagnosis (r = 0.79, P < 0.0001).

CONCLUSIONS:

In the DAISY cohort, 89% of children who progressed to diabetes expressed two or more autoantibodies. Age of diagnosis of diabetes is strongly correlated with age of appearance of first autoantibody and IAA levels.

PMID:
21562325
[PubMed - indexed for MEDLINE]
PMCID:
PMC3114355
Free PMC Article

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