Format

Send to

Choose Destination
Pediatr Diabetes. 2014 Mar;15(2):118-26. doi: 10.1111/pedi.12066. Epub 2013 Aug 27.

Children followed in the TEDDY study are diagnosed with type 1 diabetes at an early stage of disease.

Collaborators (213)

Rewers M, Barriga K, Bautista K, Baxter J, Eisenbarth G, Frank N, Gesualdo P, Hoffman M, Ide L, Karban R, Liu E, Norris J, Waugh K, Samper-Imaz A, Steck A, She JX, Schatz D, Hopkins D, Steed L, Thomas J, Silvis K, Haller M, Shankar M, Gardiner M, McIndoe R, Liu H, Nechtman J, Sharma A, Williams J, Foghis G, Anderson SW, Ziegler AG, Beyerlein A, Bonifacio E, Henneberger L, Hummel M, Hummel S, Foterek K, Kersting M, Knopff A, Koletzko S, Krause S, Peplow C, Pflüger M, Roth R, Schenkel J, Stock J, Strauss E, Warncke K, Winkler C, Simell OG, Hyöty H, Ilonen J, Knip M, Lönnrot M, Mantymaki E, Mykkänen J, Nanto-Salonen K, Niininen T, Nyblom M, Riikonen A, Romo M, Simell B, Simell T, Simell V, Sjöberg M, Stenius A, Toppari J, Varjonen E, Veijola R, Virtanen SM, Lernmark Å, Agardh D, Andrén-Aronsson C, Ask M, Bremer J, Cilio C, Ericson-Hallström E, Fransson L, Gard T, Gerardsson J, Hansson G, Hansen M, Hyberg S, Johansen F, Jonasdottir B, Karlsson UM, Larsson HE, Lernmark B, Markan M, Massadakis T, Melin J, Månsson-Martinez M, Nilsson A, Rahmati K, Järvirova MS, Sibthorpe S, Sjöberg B, Swartling U, Trulsson E, Törn C, Wallin A, Wimar Å, Åberg S, Hagopian WA, Yan X, Killian M, Crouch CC, Hay KM, Ayres S, Adams C, Bratrude B, Coughlin D, Fowler G, Franco C, Hammar C, Heaney D, Marcus P, Meyer A, Mulenga D, Scott E, Skidmore J, Stabbert J, Stepitova V, Williams N, Becker D, Franciscus M, Dalmagro-Elias M, Daftary A, Krischer JP, Abbondondolo M, Austin S, Brown R, Burkhardt B, Butterworth M, Cuthbertson D, Eberhard C, Fiske S, Gowda V, Hadley D, Lee HS, Liu S, Lynch K, Malloy J, McCarthy C, McLeod W, Smith L, Smith S, Tamura R, Uusitalo U, Vehik K, Washington E, Yang J, Akolkar B, Bourcier K, Briese T, Johnson SB, Oberste S, Triplett E, Yu L, Miao D, Bingley P, Williams A, Chandler K, Rokni S, Long A, Boldison J, Butterly J, Broadhurst J, Carreno G, Curnock R, Easton P, Geoghan I, Goode J, Pearson J, Reed C, Ridewood S, Wyatt R, Eriksson EA, Karlsson EL, Erlund I, Salminen I, Sundvall J, Leiviskä J, Lehtonen M, Little RR, Tennill AL, Erlich H, Bugawan T, Alejandrino M, Fiehn O, Wikoff B, Kind T, Palazoglu M, Wong J, Wohlgemuth G, She JX, Petrosino JF, Marcovina SM, Higgins H, Ke S, McIndoe R, Liu H, Nechtman J, Zhao Y, Jiang N, Onengut-Gumuscu S, Rich SS, Chen WM, Farber E, Pickin RR, Davis J, Gallo D.

Author information

1
Department of Clinical Sciences, Lund University, Skåne University Hospital SUS, Malmö, Sweden.

Abstract

OBJECTIVE:

The Environmental Determinants of Diabetes in the Young (TEDDY) study is designed to identify environmental exposures triggering islet autoimmunity and type 1 diabetes (T1D) in genetically high-risk children. We describe the first 100 participants diagnosed with T1D, hypothesizing that (i) they are diagnosed at an early stage of disease, (ii) a high proportion are diagnosed by an oral glucose tolerance test (OGTT), and (iii) risk for early T1D is related to country, population, human leukocyte antigen (HLA)-genotypes and immunological markers.

METHODS:

Autoantibodies to glutamic acid decarboxylase (GADA), insulinoma-associated protein 2 (IA-2) and insulin (IAA) were analyzed from 3 months of age in children with genetic risk. Symptoms and laboratory values at diagnosis were obtained and reviewed for ADA criteria.

RESULTS:

The first 100 children to develop T1D, 33 first-degree relatives (FDRs), with a median age 2.3 yr (0.69-6.27), were diagnosed between September 2005 and November 2011. Although young, 36% had no symptoms and ketoacidosis was rare (8%). An OGTT diagnosed 9/30 (30%) children above 3 yr of age but only 4/70 (5.7%) below the age of 3 yr. FDRs had higher cumulative incidence than children from the general population (p < 0.0001). Appearance of all three autoantibodies at seroconversion was associated with the most rapid development of T1D (HR = 4.52, p = 0.014), followed by the combination of GADA and IAA (HR = 2.82, p < 0.0001).

CONCLUSIONS:

Close follow-up of children with genetic risk enables early detection of T1D. Risk factors for rapid development of diabetes in this young population were FDR status and initial positivity for GADA, IA-2, and IAA or a combination of GADA and IAA.

KEYWORDS:

TEDDY study; autoantibodies; diagnosis; follow-up studies; type 1 diabetes

PMID:
24034790
PMCID:
PMC3866211
DOI:
10.1111/pedi.12066
[Indexed for MEDLINE]
Free PMC Article

Supplemental Content

Full text links

Icon for Wiley Icon for PubMed Central
Loading ...
Support Center