Diabetes registries and early biological markers of insulin-dependent diabetes mellitus

Gorus, Frans

doi:10.1002/(sici)1099-0895(199712)13:4<247::aid-dmr196>3.0.co;2-v

Cited by 40 publications

(51 citation statements)

References 118 publications

(282 reference statements)

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“…In the age group 25 to 29 years the male to female incidence rate ratio was equal to or greater than 1.5 in all centres, although this was not statistically significant in Antwerp and Leicestershire, the two centres with the smallest study populations [21,31]. However, the Belgian Diabetes Registry has shown a significant difference between incidence rates in men and women (p<0.001) in the age range 15 to 39 years [21,32].…”

Section: Discussionmentioning

confidence: 75%

The epidemiology of Type 1 diabetes mellitus is not the same in young adults as in children

et al. 2004

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Aims/hypothesis. This prospective study examined the epidemiology of Type 1 diabetes in young adults in Europe. Methods. We ascertained incident cases of Type 1 diabetes in the 15 to 29 years (both inclusive) age group throughout Europe over a period of 2 years. Diabetes registries in nine countries, in which incidence rates for Type 1 diabetes in the 0 to 14 age group were available, took part. Incidence rates were estimated per 100000 person years and standardised for sex and age. Cumulative incidences per 1000 from birth to age 30 were estimated. Heterogeneity between centres was tested with a Poisson regression model. Results. A total of 2112 diabetes cases were ascertained in 1996 and 1997, of which 61.4% were considered to be Type 1 diabetes. Completeness of ascertainment varied from 70 to 90%. Standardised incidence varied from 4.8 per 100000 person years to 13.4 per 100000 person years. The male-female ratio was estimated to be one or more, and in the 25 to 29 age group 1.5 or more in all countries. Cumulative incidences for males and females indicate that the former exceeds the latter from age 24. In the two centres with highest childhood incidence, this applied already from 14 years of age. Conclusions/interpretation. The incidence of Type 1 diabetes in adults is lower than in children and the range of incidence is also reduced, with a less than threefold variation in adults, against an eightfold variation in children. There is a male excess in incidence, especially in the age group 25 to 29 years.

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Section: Discussionmentioning

confidence: 75%

The epidemiology of Type 1 diabetes mellitus is not the same in young adults as in children

et al. 2004

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“…The histopathological hallmarks of the disease comprise a markedly reduced ␤-cell mass and a focal infiltration of the islets by mononuclear cells termed insulitis (2). Very little is known about the nature, intensity, and kinetics of the underlying histopathological lesions during the allegedly long preclinical disease phase (3,4). Serendipitous anatomopathological observations in diabetic patients who died days to years after diagnosis have revealed a marked heterogeneity in the intensity of these histopathological changes at clinical onset and with disease duration (3).…”

Section: Diabetes Care 23:1072-1078 2000mentioning

confidence: 99%

“…Clinical onset of type 1 diabetes is almost always preceded and accompanied by the presence of insulin autoantibodies (IAA) or autoantibodies against as yet incompletely identified cytoplasmic islet cell antigens, known as islet cell Decochez and Associates cytoplasmic antibodies (ICA) (4,(7)(8)(9)(10)(11)(12)(13)(14). Antibodies against GAD (GADA) and IA-2 protein tyrosine phosphatase (IA-2A) have been proposed as major constituents of ICA (15).…”

Section: Diabetes Care 23:1072-1078 2000mentioning

confidence: 99%

“…Antibodies against GAD (GADA) and IA-2 protein tyrosine phosphatase (IA-2A) have been proposed as major constituents of ICA (15). Detection of these different antibodies constitutes the cornerstone of early diagnosis and classification of type 1 diabetes (4,(7)(8)(9)(10)(11)(12)(13)(14). However, it remains largely unknown how the presence of these antibodies relates to the intensity and evolution of the underlying disease process in the pancreas (such as insulitis and ␤-cell aggression or death), to associated defense mechanisms (such as cellular repair and regeneration), or to the effects of insulin treatment (3,4,16,17).…”

Section: Diabetes Care 23:1072-1078 2000mentioning

confidence: 99%

“…The data collected by the BDR have been shown to be representative of the Belgian population of type 1 diabetic patients (4,28). The study group comprised 160 (93%) patients who were antibody-positive (for ICA, IA-2A, GADA, and/or IAA) and 12 (7%) who were antibody-negative at the time of diagnosis.…”

Section: Subjectsmentioning

confidence: 99%

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Use of an islet cell antibody assay to identify type 1 diabetic patients with rapid decrease in C-peptide levels after clinical onset. Belgian Diabetes Registry.

Decochez

Keymeulen²,

Somers³

et al. 2000

Diabetes Care

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OBJECTIVE -To investigate whether the presence of antibody markers at diagnosis could help predict the rapid decrease in residual ␤-cell function noted in some, but not all, patients with recent-onset type 1 diabetes.RESEARCH DESIGN AND METHODS -We measured random C-peptide levels (radioimmunoassay); islet cell cytoplasmic antibodies (ICA) (indirect immunofluorescence); and antibodies against IA-2 protein, 65-kDa glutamate decarboxylase, and insulin (liquid-phase radiobinding assays) in 172 patients Ͻ40 years of age with type 1 diabetes. The patients had been consecutively recruited at diagnosis by the Belgian Diabetes Registry and were followed for 2 years.RESULTS -Two years after diagnosis, random C-peptide levels had decreased significantly (P Ͻ 0.001) in ICA ϩ patients but not in ICA Ϫ patients. C-peptide values Ͻ50 pmol/l were noted in 88% of patients diagnosed before 7 years of age, in 45% of patients diagnosed between ages 7 and 15 years, and in 29% of patients diagnosed after 15 years of age (P Ͻ 0.001). In cases of clinical onset before age 15 years, a rapid decline in random C-peptide values was observed almost exclusively in patients with high-titer ICA (Ն50 Juvenile Diabetes Foundation [JDF] units) at diagnosis (69 vs. 17% in patients with lower ICA titers, P Ͻ 0.001). In patients diagnosed after 15 years of age, 36% of patients with ICA titers Ն12 JDF units developed low C-peptide levels compared with 14% of patients with ICA titers Ͻ12 JDF units (P Ͻ 0.03). Multivariate analysis confirmed that C-peptide levels after 2 years were inversely correlated with ICA levels (P Ͻ 0.001) and to a lesser degree positively correlated with age at diagnosis (P Ͻ 0.02), regardless of the levels or number of molecular autoantibodies.CONCLUSIONS -Young age at diagnosis and high-titer ICA identify a group of type 1 diabetic patients at high risk of rapidly losing residual ␤-cell function. Using these selection criteria, it is possible to better target ␤-cell-preserving interventions to patients with or without such rapid progression, depending on the nature of the tested substance. The

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Discordant association of islet autoantibodies with high‐risk HLA genes in Chinese type 1 diabetes

Zhang

Chen

et al. 2011

Diabetes Metabolism Res

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Diabetes registries and early biological markers of insulin-dependent diabetes mellitus

Cited by 40 publications

References 118 publications

The epidemiology of Type 1 diabetes mellitus is not the same in young adults as in children

The epidemiology of Type 1 diabetes mellitus is not the same in young adults as in children

Use of an islet cell antibody assay to identify type 1 diabetic patients with rapid decrease in C-peptide levels after clinical onset. Belgian Diabetes Registry.

Discordant association of islet autoantibodies with high‐risk HLA genes in Chinese type 1 diabetes

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