Clinical Characteristics in Swedish Children With and Without Autoantibodies at the Time of Type 1 Diabetes Diagnosis
(2025) In Diabetes Care 48.- Abstract
OBJECTIVE: Autoantibodies have long been recognized as biomarkers of islet autoimmunity in type 1 diabetes, but their role in the pathogenesis is not fully understood. The aim of this study was to analyze clinical and hereditary characteristics of children presenting with and without autoantibodies at type 1 diabetes diagnosis.
RESEARCH DESIGN AND METHODS: Data were collected from children (<18 years) at the time of diabetes diagnosis as part of Sweden's national Better Diabetes Diagnosis study. Participants were categorized based on the presence or absence of autoantibodies. Variables compared were age at diagnosis, sex, HbA1c, diabetic ketoacidosis (DKA), parental heredity of type 1 and type 2 diabetes, level of C-peptide,... (More)
OBJECTIVE: Autoantibodies have long been recognized as biomarkers of islet autoimmunity in type 1 diabetes, but their role in the pathogenesis is not fully understood. The aim of this study was to analyze clinical and hereditary characteristics of children presenting with and without autoantibodies at type 1 diabetes diagnosis.
RESEARCH DESIGN AND METHODS: Data were collected from children (<18 years) at the time of diabetes diagnosis as part of Sweden's national Better Diabetes Diagnosis study. Participants were categorized based on the presence or absence of autoantibodies. Variables compared were age at diagnosis, sex, HbA1c, diabetic ketoacidosis (DKA), parental heredity of type 1 and type 2 diabetes, level of C-peptide, BMI SD score (SDS), and HLA genotype. We used t tests, χ2 tests, and logistic regression for comparisons.
RESULTS: Of the 2,753, children, 169 (6.1%) were autoantibody-negative at type 1 diabetes diagnosis. Of those, 66% were boys compared with 56% of children with autoantibodies (P = 0.009). Also, children without autoantibodies had higher HbA1c at diagnosis (11.3 vs. 10.8% [100 vs. 94 mmol/mol], P = 0.003), were less likely to present with DKA (9 vs. 15%, P = 0.039), and more likely to have parental history of type 2 diabetes (8 vs. 2%, P < 0.001) compared with children with autoantibodies. We did not observe differences for age at diagnosis, C-peptide levels, BMI-SDS, or HLA genotype between the children with and without autoantibodies.
CONCLUSIONS: We identified differences in clinical characteristics when comparing children with and without autoantibodies at type 1 diabetes diagnosis, highlighting potential heterogeneity in the disease's pathogenesis across subgroups.
(Less)
- author
- Hedlund, Emma
LU
; Maziarz, Marlena
LU
; Lindahl, Tomas
; Elding-Larsen, Helena
LU
; Forsander, Gun
; Persson, Martina
; Pundziute-Lyckå, Auste
; Åkesson, Karin
; Ludvigsson, Johnny
and Carlsson, Annelie
LU
- organization
- publishing date
- 2025-10-15
- type
- Contribution to journal
- publication status
- epub
- subject
- in
- Diabetes Care
- volume
- 48
- publisher
- American Diabetes Association
- external identifiers
-
- pmid:41091947
- ISSN
- 1935-5548
- DOI
- 10.2337/dc25-0840
- language
- English
- LU publication?
- yes
- additional info
- © 2025 by the American Diabetes Association.
- id
- 518a188e-8f92-4e00-97fb-dbc5ab809a92
- date added to LUP
- 2025-10-21 14:18:49
- date last changed
- 2025-10-22 03:19:13
@article{518a188e-8f92-4e00-97fb-dbc5ab809a92,
abstract = {{<p>OBJECTIVE: Autoantibodies have long been recognized as biomarkers of islet autoimmunity in type 1 diabetes, but their role in the pathogenesis is not fully understood. The aim of this study was to analyze clinical and hereditary characteristics of children presenting with and without autoantibodies at type 1 diabetes diagnosis.</p><p>RESEARCH DESIGN AND METHODS: Data were collected from children (<18 years) at the time of diabetes diagnosis as part of Sweden's national Better Diabetes Diagnosis study. Participants were categorized based on the presence or absence of autoantibodies. Variables compared were age at diagnosis, sex, HbA1c, diabetic ketoacidosis (DKA), parental heredity of type 1 and type 2 diabetes, level of C-peptide, BMI SD score (SDS), and HLA genotype. We used t tests, χ2 tests, and logistic regression for comparisons.</p><p>RESULTS: Of the 2,753, children, 169 (6.1%) were autoantibody-negative at type 1 diabetes diagnosis. Of those, 66% were boys compared with 56% of children with autoantibodies (P = 0.009). Also, children without autoantibodies had higher HbA1c at diagnosis (11.3 vs. 10.8% [100 vs. 94 mmol/mol], P = 0.003), were less likely to present with DKA (9 vs. 15%, P = 0.039), and more likely to have parental history of type 2 diabetes (8 vs. 2%, P < 0.001) compared with children with autoantibodies. We did not observe differences for age at diagnosis, C-peptide levels, BMI-SDS, or HLA genotype between the children with and without autoantibodies.</p><p>CONCLUSIONS: We identified differences in clinical characteristics when comparing children with and without autoantibodies at type 1 diabetes diagnosis, highlighting potential heterogeneity in the disease's pathogenesis across subgroups.</p>}},
author = {{Hedlund, Emma and Maziarz, Marlena and Lindahl, Tomas and Elding-Larsen, Helena and Forsander, Gun and Persson, Martina and Pundziute-Lyckå, Auste and Åkesson, Karin and Ludvigsson, Johnny and Carlsson, Annelie}},
issn = {{1935-5548}},
language = {{eng}},
month = {{10}},
publisher = {{American Diabetes Association}},
series = {{Diabetes Care}},
title = {{Clinical Characteristics in Swedish Children With and Without Autoantibodies at the Time of Type 1 Diabetes Diagnosis}},
url = {{http://dx.doi.org/10.2337/dc25-0840}},
doi = {{10.2337/dc25-0840}},
volume = {{48}},
year = {{2025}},
}