HLA-typing, clinical, and immunological characterization of youth with type 2 diabetes mellitus phenotype from the German/Austrian DPV database

Awa, Wendy L; Boehm, B.O.; Rosinger, Silke; Achenbach, Peter; Ziegler, Anette G.; Krause, Stephanie; Meißner, Thomas; Wiegand, Susanna; Reinehr, Thomas; Kapellen, Thomas; Karges, Beate; Eiermann, Thomas; Schober, Edith; Holl, Reinhard W.; Dpv, Initiative

doi:10.1111/pedi.12043

Cited by 26 publications

(33 citation statements)

References 34 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Routine measurement of these autoantibodies in the immediate period after diagnosis increases the rate of autoantibody positivity 19. Third, differences exist in rates of autoantibody-positive T2D children between studies: 12.6%, 9.8% and 15% of T2D children were autoantibody positive during the SEARCH, TODAY and German/Austrian studies, respectively, compared with 30% in our UK clinic cohort 6 15 16. This may reflect differences in criteria for diabetes classification, ethnicity and the other reasons mentioned above.…”

Section: Discussionmentioning

confidence: 83%

See 1 more Smart Citation

Islet autoantibody status in a multi-ethnic UK clinic cohort of children presenting with diabetes

et al. 2014

View full text Add to dashboard Cite

ObjectiveWe prospectively determined islet autoantibody status in children presenting with diabetes to a single UK region in relation to ethnicity.Design316 (68.0% non-white) children presenting with diabetes between 2006 and 2013 were tested centrally for islet cell autoantibodies (ICA) and glutamic acid decarboxylase autoantibodies (GAD-65) at diagnosis, and if negative for both, tested for insulin autoantibodies (IAA). The assay used to measure GAD-65 autoantibodies changed from an in-house to a standardised ELISA method during the study.ResultsEven with use of the standardised ELISA method, 25.8% of children assigned a diagnosis of type 1 diabetes still tested negative for all three autoantibodies. 30% of children assigned a diagnosis of type 2 diabetes were autoantibody positive, and these had the highest glycated haemoglobin (HbA1c) levels at 12 months follow-up compared with other groups (p value for analysis of variance <0.001), although the sample size was small. Autoantibody positivity was similar between non-white and white children regardless of assay used (60.0% (n=129) vs 56.4% (n=57), χ2=0.9, p=0.35), as was mean GAD-65 autoantibody levels, but fewer non-white children had two or more autoantibodies detectable (13% (n=28) vs 27.7% (n=28), χ2=12.1, p=0.001).ConclusionsIslet autoantibody positivity was associated with a more severe phenotype, as demonstrated by poorer glycaemic control, regardless of assigned diabetes subtype. Positivity did not differ by ethnic group.

show abstract

Section: Discussionmentioning

confidence: 83%

“…Studies that have added to our knowledge of the phenotype of children presenting with diabetes include the landmark US SEARCH6 and TODAY Studies,15 a study in German and Austrian youths,16 and the Childhood Diabetes in Finland Study 17. The TODAY and German/Austrian studies were limited to patients with T2D.…”

Section: Discussionmentioning

confidence: 99%

Islet autoantibody status in a multi-ethnic UK clinic cohort of children presenting with diabetes

et al. 2014

View full text Add to dashboard Cite

show abstract

“…But only 51.3% of our analysed people with autoimmune diabetes had a normal body mass index (Table 1) which is only slightly better than the average non diabetic German population where only 48% have a normal body mass index [21]. Therefore increasing interest should be directed to the field of double diabetes, defined as T1DM mellitus with criteria of the MS [2,7,8,22]. Since patients with MS show an augmented cardiovascular risk, increasing effort should be taken to identify persons with T1DM…”

Section: Discussionmentioning

confidence: 97%

Prevalence and comorbidities of double diabetes

Merger

Kerner²,

Stadler

et al. 2016

Diabetes Research and Clinical Practice

View full text Add to dashboard Cite

Statement of all funding sources: BMBF Kompetenznetz Diabetes mellitus (FKZ 01GI1106); DZD; EFSD, BMBF Kompetenznetz Adipositas (FKZ01GI1130)Conflicts of interest The authors have no conflict of interest to declare.Key words: double diabetes, T1DM, diabetes mellitus type 1, insulin resistance, diabetic nephropathy, macroangiopathy, microangiopathy, coronary heart disease, LADA Novelty statement: The outlined paper analyzes 392 diabetes centers with 31119 patients with autoimmune diabetes for the prevalence and comorbidities of double diabetes. We could show for the first time that insulin requirement or insulin resistance is an independent risk factor for patients with type 1 diabetes and that even in well controlled diabetes an additional metabolic syndrome is a major risk factor for developing macrovascular as well as microvascular complications. Aim of this cross sectional study is to better estimate the prevalence of MS in T1DM, and to assess its association with comorbidities. AbbreviationsMethods: Data of 31119 persons with autoimmune diabetes mellitus were analyzed for signs of MS and presence of late complications. Double diabetes was defined as T1DM coexisting with MS (obesity, hypertension, dyslipidemia). Multiple linear or logistic regression analyses were performed to identify associations between double diabetes and late complications.Results: 25.5% (n=7926) of persons with T1DM presented additionally the MS. Persons with double diabetes showed significantly more macrovascular comorbidities (coronary heart disease 8.0 versus 3.0% w/o MS, stroke 3.6 versus 1.6%, diabetic foot syndrome 5.5% versus 2.1%).Also microvascular diseases were increased in people with double diabetes (retinopathy 32.4% versus 21.7%, nephropathy 28.3% versus 17.8%). Both macrovascular and microvascular comorbidities were increased independent of glucose control, even if patients with good metabolic control (HbA1c <7.0%, 53mmol/mol) showed significantly less macrovascular (coronary heart disease 2.3% versus 1.8%, p<0.0001) and microvascular problems (retinopathy 8.7% versus 6.6%, p<0.0001).Conclusions: Double diabetes seems to be an independent and important risk factor for persons with T1DM in developing macrovascular and microvascular comorbidities. Therefore, patients should be identified and development of MS should be avoided. Longtermstudies are needed to observe the effect of insulin resistance on patients with autoimmune diabetes.

show abstract

“…Briefly, T2DM was diagnosed based on the criteria of the American Diabetes Association identical to German guidelines (26). In none of the adolescents with T2DM autoantibodies were detectable and maturity onset of diabetes in youth (MODY) was excluded by genetic analyses (25). The obese adolescents without T2DM were recruited from the obesity cohort at the outpatient obesity clinic of the Vestische Children's Hospital, University of Witten/Herdecke (for details see (2)).…”

Section: Subjectsmentioning

confidence: 99%

“…Adolescents with T2DM were recruited from the DPV dataset (for details of this cohort see (2,25)). Briefly, T2DM was diagnosed based on the criteria of the American Diabetes Association identical to German guidelines (26).…”

Section: Subjectsmentioning

confidence: 99%

Fibroblast Growth Factor 21 and Fetuin-A in Obese Adolescents With and Without Type 2 Diabetes

Reinehr¹,

Karges

Meißner

et al. 2015

The Journal of Clinical Endocrinology & Metabolism

Self Cite

View full text Add to dashboard Cite

show abstract

HLA-typing, clinical, and immunological characterization of youth with type 2 diabetes mellitus phenotype from the German/Austrian DPV database

Abstract: T2DM was confirmed in about 90% of patients while about 10% with β-cell autoimmunity or HLA-DR genetic risk likely had either T1.5DM or 'double diabetes' or an unknown diabetes type.

Cited by 26 publications

References 34 publications

Islet autoantibody status in a multi-ethnic UK clinic cohort of children presenting with diabetes

Islet autoantibody status in a multi-ethnic UK clinic cohort of children presenting with diabetes

Prevalence and comorbidities of double diabetes

Fibroblast Growth Factor 21 and Fetuin-A in Obese Adolescents With and Without Type 2 Diabetes

Contact Info

Product

Resources

About