Improving Prediction of Risk for the Development of Type 1 Diabetes-Insights From Populations at High Risk
| Autor: | Diane K. Wherrett |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
Advanced and Specialized Nursing
Type 1 diabetes Pediatrics medicine.medical_specialty business.industry Endocrinology Diabetes and Metabolism Autoantibody Human leukocyte antigen medicine.disease Diabetes mellitus Commentaries Genotype Internal Medicine Genetic predisposition medicine Longitudinal cohort business Immune activation |
| Zdroj: | Diabetes Care |
| ISSN: | 1935-5548 |
| Popis: | Prevention of type 1 diabetes has been brought closer to reality through the ability to identify populations at increased risk and through therapies that can modify the disease course (1). Identification of those who are at risk is based on the detection of diabetes-related autoantibodies (Ab) that can be found many years before clinical diagnosis. Those identified as being at increased risk due to having a family member who lives with type 1 diabetes or who have an increased genetic risk based on high-risk HLA have been followed in a number of longitudinal cohort studies (2–8) The preclinical phase of type 1 diabetes is described as progression from genetic susceptibility and immune activation to the development of single and then multiple Ab, to early abnormalities of glucose tolerance, and finally to clinical diabetes (9). Those who are found to have multiple Ab almost inevitably progress to diabetes (10). However, the time from detection of multiple Ab to diagnosis varies widely. To move the goal of the prevention of type 1 diabetes from research to clinical reality, refinements of strategies to predict progression to diabetes are needed. Anand et al. (11) and Bonifacio et al. (12), in two articles in this issue of Diabetes Care , help to define characteristics of Ab development and diabetes progression in >24,000 children at risk. The work by Anand et al. brings together data from five cohorts with a focus on the risk associated with the age at autoantibody (Ab) development, the number of Ab, and the HLA-DR-DQ genotype. The >16,000 children in these cohorts came from Germany, Sweden, Finland, Washington state, and Colorado and were tested for Ab before the age of 2.5 years and then followed … |
| Databáze: | OpenAIRE |
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