Analysis of Metabolic Progression to Type I Diabetes in ICA+ Relatives of Patients With Type I Diabetes
| Autor: | George S. Eisenbarth, David Bleich, J. Stuart Soeldner, Richard A. Jackson |
|---|---|
| Rok vydání: | 1990 |
| Předmět: |
Adult
Blood Glucose Male medicine.medical_specialty Time Factors Adolescent Intravenous Glucose Tolerance Endocrinology Diabetes and Metabolism medicine.medical_treatment Overt diabetes Prediabetic State Fasting glucose Islets of Langerhans Internal medicine Diabetes mellitus Diseases in Twins Internal Medicine medicine Humans Insulin Family Child Autoantibodies Advanced and Specialized Nursing geography geography.geographical_feature_category business.industry Twins Monozygotic Glucose Tolerance Test Islet medicine.disease Predictive value Diabetes Mellitus Type 1 Endocrinology Child Preschool Type i diabetes Female business Biomarkers |
| Zdroj: | Diabetes Care. 13:111-118 |
| ISSN: | 1935-5548 0149-5992 |
| Popis: | We intensively studied 5 islet cell-antibody-positive (ICA+) first-degree relatives of type I (insulin-dependent) diabetic patients before overt diabetes. In total, 55 intravenous glucose tolerance tests (IVGTTs) and 83 fasting plasma glucose determinations were made over a maximum 4-yr period before diabetes. The 5 prediabetic relatives (not diabetic when initially studied but subsequently progressed to overt diabetes) as a group showed a progressive rise in fasting glucose (r = 0.58, P < 0.001, slope = 23.1 mg · dl1 yr1) and glucose at 60 min in IVGTT (r = 0.46, P = 0.01, slope = 47.5 mg · dl-1) beginning 1.5 yr before diabetes. During the 4.0- to 1.5-yr period before overt diabetes, no change was observed in fasting glucose or glucose at 60 min on IVGTT (fasting glucose: r = 0.21, P = 0.18, slope = 2.1 mg · dl-1 · yr-1; 60-min glucose: r = 0.08, P = 0.72, slope = 2.9 mg · dl-1 · yr-1). The positive predictive value for a fasting glucose >;108 mg/dl to be within 1.5 yr of diabetes was 100% (11 of 11 values). The negative predictive value of a stimulated insulin (1-min + 3-min insulin - 2 × basal insulin) level >24 μU/ml to be >1.5 yr from diabetes was 90% (9 of 10 values) and 100% (10 of 10 values) at >1 yr from overt diabetes. We tested these predictive values by applying fasting glucose >108 mg/dl and stimulated insulin >24 μU/ml to another prediabetic group (n = 14) not included in the original analysis because each individual had fewer measurements. Once again, the positive predictive value that diabetes would develop within 1.5 yr from the time of fasting glucose >108 mg/dl was 100% (5 of 5 values), and the negative predictive value of stimulated insulin >24 μU/ml was 63% (5 of 8 values) for 1.5 yr and 89% (6 of 7 values) for 1 yr. Finally, 16 ICA+ relatives who had not yet become diabetic lacked raised fasting glucose levels (14 of 16 patients) and had stimulated insulin levels >24 μU/ml. |
| Databáze: | OpenAIRE |
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