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Development of Islet Cell Autoantibodies and Type 1 Diabetes FREE

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The summary below is from the full report titled “Brief Communication: Early Appearance of Islet Autoantibodies Predicts Childhood Type 1 Diabetes in Offspring of Diabetic Parents.” It is in the 1 June 2004 issue of Annals of Internal Medicine (volume 140, pages 882-886). The authors are M. Hummel, E. Bonifacio, S. Schmid, M. Walter, A. Knopff, and A.-G. Ziegler.


Ann Intern Med. 2004;140(11):I-64. doi:10.7326/0003-4819-140-11-200406010-00004
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What is the problem and what is known about it so far?

Diabetes interferes with the body's ability to store energy from food. The pancreas makes a substance called insulin that helps with this energy storage. Type 1 diabetes, also called juvenile diabetes because it is usually diagnosed before adulthood, occurs when the pancreas stops making insulin. The result is high blood sugar levels. Over time, high blood sugar levels can lead to blindness, kidney failure, nerve damage, and heart disease. Fortunately, good care with diet; exercise; and medications to control blood sugar level, blood pressure, and cholesterol level helps to prevent these complications. People with type 1 diabetes develop an abnormal immune reaction that causes the body to make substances called autoantibodies, which attack the insulin-producing cells (called islet cells) in the pancreas. There are several different types of autoantibodies, which are called islet cell autoantibodies. People whose first-degree relatives (parents, siblings, or children) have type 1 diabetes are at greater risk for the disease than people without a family history. An important concern of people with type 1 diabetes is whether their children will also develop the disease. Measuring autoantibodies might be useful in predicting who will develop diabetes.

Why did the researchers do this particular study?

To explore the relationship between the development of islet cell autoantibodies and the development of type 1 diabetes among children of parents with the disease.

Who was studied?

1610 children who had at least 1 parent with type 1 diabetes. All of the children were participating in a large study of type 1 diabetes, the German BABYDIAB study.

How was the study done?

The researchers enrolled the children at birth and collected blood samples and health information at birth; 9 months of age; and 2, 5, 8, and 11 years of age. They tested the blood samples for 3 different islet cell autoantibodies and for the presence of diabetes. The researchers then calculated the risk for developing diabetes according to the number of autoantibodies that a patient had and the age at which the autoantibodies first appeared.

What did the researchers find?

Of the 1610 children studied, 24 developed diabetes by the end of the follow-up period. Children were most likely to develop diabetes if they were autoantibody positive for more than 1 type of antibody. Those who had developed at least 1 antibody by 2 years of age had the greatest chance of developing diabetes by the end of the study period.

What were the limitations of the study?

These results apply only to children who have at least 1 parent with type 1 diabetes. The relationship between autoantibodies and the development of diabetes might be different in people who do not have a family history of the disease.

What are the implications of the study?

Measuring islet cell antibodies might help doctors to estimate the chance of type 1 diabetes in children with a parent who has the disease.

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