Tuesday , November 21 2017
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Predictors of Type 1 Diabetes

Physical inactivity, preproinsulin, and inflammatory markers are predictors for type 1 diabetes…. 

In a study following over 2,500 children from 1993 onward, Rewers et al found that lower physical activity in children correlated with persistent islet autoantibodies to insulin. Controls and treatment groups were similar in terms of age, BMI, and waist circumference. Of the 2,547 children at increased risk for type 1 diabetes, 198 developed persistent islet autoantibodies. These children spent less time engaging in physical activity and took fewer steps than controls.

Culina et al discovered that fetal transfer of preproinsulin (PPI) through neonatal Fc receptor protects from type 1 diabetes. PPI is the initial antigen triggering the failure of immune tolerance towards beta cells. The researchers hypothesized and concluded that PPI coupled with neonatal Fc receptor could be efficiently transferred from mother to fetus, further allowing the fetus’ immune system to develop tolerance towards PPI before autoimmune epitope spreads. One single lose dose 100microgram injection of PPI-Fc was sufficient to protect from fetus from type 1 diabetes.

Siewko et al conducted an experiment on first degree relatives of type 1 diabetes patients and healthy patients in order to investigate whether inflammatory markers are associated with decreased insulin sensitivity and beta cell function. They found that CRP and TNFα concentrations were significantly higher in first degree relatives of type 1 diabetes patients.

Practice Pearls:
  • Physical inactivity correlates with persistent islet autoantibodies to insulin.
  • An injection of preproinsulin to pregnant women protects offspring from developing T1DM.
  • CRP and TNFα are elevated in first degree relatives of T1DM patients.

EASD Barcelona, September 26 2013

  1. M Rewers, K Waugh, K Barriga, J Norris, J Snell-Bergeon. Lower physical activity in children with persistent islet autoantibodies than in matched controls.
  2. S Culina, R Boisgard, N Gupta, S Lacroix-Desmazes, R Mallone. Foetal transfer of preproinsulin through the neonatal Fc receptor protects from type 1 diabetes
  3. K Siewko, M Szelachowska, A Poplawska-Kita, D Lipinska, A Nikolajuk, M Gorska.Relationship of serum cytokines and proinflammatory markers to development of type 1 diabetes.