Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions
Approach May Predict Preclinical Transitions in T1D
Diabetes Care; ePub 2016 Apr 20; Xu, et al
A new classification approach might be able to predict the timing of transitions between preclinical stages in people developing type 1 diabetes, according to an analysis of 3 cohorts from the Type 1 Diabetes TrialNet Pathway to Prevention Study.
Investigators looked at the cohorts separately, analyzing genotype, antibody titers, and metabolic markers. Among the results:
• Age and GAD65 autoantibody titers defined 3 risk classes for progression from single to multiple autoantibodies.
• The 5-year risk was 11% for those >16 years of age with low GAD65Ab titers; 29% for those ≤16 years of age with low GAD65Ab titers; and 45% for those with high GAD65Ab titers regardless of age.
• Progression to dysglycemia was linked with islet antigen 2 Ab titers, as well as 2-h glucose and fasting C-peptide levels.
• Progression to type 1 diabetes was linked with the number of positive autoantibodies, peak C-peptide level, HbA1c level, and age.
The authors noted that their finding means that new prevention techniques can be tailored based on risk characteristics at different preclinical stages.
Citation: Xu P, Krischer, et al. Prognostic Classification Factors Associated with Development of Multiple Autoantibodies, Dysglycemia, and Type 1 Diabetes—A Recursive Partitioning Analysis. [Published online ahead of print April 20, 2016]. Diabetes Care. doi:10.2337/dc15-2292.