Characteristics of the pre-diabetic period in children with high risk of type 1 diabetes recruited from the general Swedish population-The ABIS study
(2017) In Diabetes/Metabolism Research and Reviews 33(6).- 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
- Åkerman, Linda ; Ludvigsson, Johnny ; Swartling, Ulrica LU and Casas, Rosaura
- organization
- publishing date
- 2017
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- Islet autoantibodies, Pre-diabetes, T1D high-risk, Type 1 diabetes
- in
- Diabetes/Metabolism Research and Reviews
- volume
- 33
- issue
- 6
- article number
- e2900
- publisher
- John Wiley & Sons Inc.
- external identifiers
-
- pmid:28371132
- wos:000409108000006
- 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
- 2024-06-09 18:51:34
@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}},
keywords = {{Islet autoantibodies; Pre-diabetes; T1D high-risk; Type 1 diabetes}},
language = {{eng}},
number = {{6}},
publisher = {{John Wiley & Sons Inc.}},
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}},
doi = {{10.1002/dmrr.2900}},
volume = {{33}},
year = {{2017}},
}