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

Åkerman, Linda; Ludvigsson, Johnny; Swartling, Ulrica LU and Casas, Rosaura (2017) In Diabetes/Metabolism Research and Reviews
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... (More)

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.

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author
organization
publishing date
type
Contribution to journal
publication status
epub
subject
keywords
Islet autoantibodies, Pre-diabetes, T1D high-risk, Type 1 diabetes
in
Diabetes/Metabolism Research and Reviews
publisher
John Wiley & Sons
external identifiers
  • scopus:85019493650
ISSN
1520-7552
DOI
10.1002/dmrr.2900
language
English
LU publication?
yes
id
39f21890-01fd-43d9-8d5f-df93122b6fb5
date added to LUP
2017-06-26 09:25:17
date last changed
2017-06-27 03:00:10
@article{39f21890-01fd-43d9-8d5f-df93122b6fb5,
  abstract     = {<p>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.</p>},
  author       = {Åkerman, Linda and Ludvigsson, Johnny and Swartling, Ulrica and Casas, Rosaura},
  issn         = {1520-7552},
  keyword      = {Islet autoantibodies,Pre-diabetes,T1D high-risk,Type 1 diabetes},
  language     = {eng},
  publisher    = {John Wiley & Sons},
  series       = {Diabetes/Metabolism Research and Reviews},
  title        = {Characteristics of the pre-diabetic period in children with high risk of type 1 diabetes recruited from the general Swedish population-The ABIS study},
  url          = {http://dx.doi.org/10.1002/dmrr.2900},
  year         = {2017},
}