Format

Send to

Choose Destination
Diabetes Metab Res Rev. 2017 Sep;33(6). doi: 10.1002/dmrr.2900. Epub 2017 May 16.

Characteristics of the pre-diabetic period in children with high risk of type 1 diabetes recruited from the general Swedish population-The ABIS study.

Author information

1
Division of Pediatrics, Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden.
2
Pediatric Clinic, County Council of Östergötland, Linköping, Sweden.
3
Division of Diabetes and Celiac disease, Department of Clinical Sciences, Lund University, Malmö, Sweden.

Abstract

BACKGROUND:

There is a need for increased understanding of the pre-diabetic period in individuals with high risk of type 1 diabetes from the general population.

METHODS:

High-risk children (n = 21) positive for multiple islet autoantibodies were identified by autoantibody screening within the All Babies in Southeast Sweden study. The children and their parents were enrolled in a 2-year prospective follow-up study aiming to characterize the pre-diabetic period. Blood samples were collected every 6 months for measurement of C-peptide, HbA1c, fasting glucose, and autoantibodies. Human leukocyte antigen-genotype was determined, and oral glucose tolerance test was performed every 12 months.

RESULTS:

Despite positivity for multiple autoantibodies, 9 out of 21 individuals had low-risk human leukocyte antigen-genotypes. Children who progressed to manifest diabetes (progressors, n = 12) had higher levels of IA2A and ZnT8A than children who did not (non-progressors, n = 9). Impaired glucose tolerance and impaired fasting glucose was observed to the same extent in progressors and non-progressors, but HbA1c increased over time in progressors in spite of increased C-peptide.

CONCLUSIONS:

Autoantibodies to IA2 and ZnT8 may be useful discriminators for disease progression in at-risk children from the general population. Dysglycemia was observed long before diagnosis, and difficulties in maintaining glucose homeostasis despite increased C-peptide indicate that insulin resistance might be an important accelerator of disease in risk individuals.

KEYWORDS:

T1D high-risk; islet autoantibodies; pre-diabetes; type 1 diabetes

PMID:
28371132
DOI:
10.1002/dmrr.2900
[Indexed for MEDLINE]

Supplemental Content

Full text links

Icon for Wiley
Loading ...
Support Center