German scientists have found clinical factors that may identify type 1 diabetes before it even occurs….
Two diabetes-related autoantibodies were found to be the strongest indicators of diabetes risk. The authors said that type 1 diabetes usually has a "preclinical phase that can be identified by the presence of autoantibodies to antigens of the pancreatic beta cells."
Data gathered from three different studies, which included a total of 13,377 children, were used in the analysis. At the 10-year follow-up, researchers found that 70 percent of the children with multiple pancreatic autoantibodies developed type 1 diabetes while 15 percent of the children with only one autoantibody developed diabetes.
Jay S. Skyler, M.D. and Jay M. Sosenko, M.D. of the University of Miami Miller School of Medicine commented in an accompanying editorial, "If you have two or more autoantibodies, it’s nearly inevitable that you will develop the disease."
The children in the study had a particular genotype indicating a genetic predisposition to type 1 diabetes. Eight percent of the children had one or more of the autoantibodies at follow-up: 585 children had at least two autoantibodies and 474 were found to have just one. Nearly half of the children with two or more autoantibodies went on to develop diabetes within five years, and 4 out of every 5 of them became diabetic within fifteen years. Only 14.5 percent of children with just one autoantibody developed type 1 diabetes after 10 years. In addition, children with more than one autoantibody before the age of 3 years were at a considerably greater risk of developing type 1 diabetes.
The authors concluded: "These data show that the detection of multiple islet autoantibodies in children who are genetically at risk marks a preclinical stage of type 1 diabetes. Thus, the development of multiple islet autoantibodies in children predicts type 1 diabetes. Future prevention studies should focus on this high-risk population."
Journal of the American Medical Association