Children followed in the TEDDY study are diagnosed with type 1 diabetes at an early stage of disease.

Elding Larsson, Helena; Vehik, Kendra; Gesualdo, Patricia; Akolkar, Beena; Hagopian, William; Krischer, Jeffery; Lernmark, Åke; Rewers, Marian; Simell, Olli; She, Jin-Xiong; Ziegler, Anette; Haller, Michael J

doi:10.1111/pedi.12066

2014

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Title:: Children followed in the TEDDY study are diagnosed with type 1 diabetes at an early stage of disease.
Document type:: Journal Article
Author(s):: Elding Larsson, Helena; Vehik, Kendra; Gesualdo, Patricia; Akolkar, Beena; Hagopian, William; Krischer, Jeffery; Lernmark, Åke; Rewers, Marian; Simell, Olli; She, Jin-Xiong; Ziegler, Anette; Haller, Michael J
Abstract:: The Environmental Determinants of Diabetes in the Young (TEDDY) study is designed to identify environmental exposures triggering islet autoimmunity and type 1 diabetes (T1D) in genetically high-risk children. We describe the first 100 participants diagnosed with T1D, hypothesizing that (i) they are diagnosed at an early stage of disease, (ii) a high proportion are diagnosed by an oral glucose tolerance test (OGTT), and (iii) risk for early T1D is related to country, population, human leukocyte antigen (HLA)-genotypes and immunological markers.Autoantibodies to glutamic acid decarboxylase (GADA), insulinoma-associated protein 2 (IA-2) and insulin (IAA) were analyzed from 3 months of age in children with genetic risk. Symptoms and laboratory values at diagnosis were obtained and reviewed for ADA criteria.The first 100 children to develop T1D, 33 first-degree relatives (FDRs), with a median age 2.3 yr (0.69-6.27), were diagnosed between September 2005 and November 2011. Although young, 36% had no symptoms and ketoacidosis was rare (8%). An OGTT diagnosed 9/30 (30%) children above 3 yr of age but only 4/70 (5.7%) below the age of 3 yr. FDRs had higher cumulative incidence than children from the general population (p < 0.0001). Appearance of all three autoantibodies at seroconversion was associated with the most rapid development of T1D (HR = 4.52, p = 0.014), followed by the combination of GADA and IAA (HR = 2.82, p < 0.0001).Close follow-up of children with genetic risk enables early detection of T1D. Risk factors for rapid development of diabetes in this young population were FDR status and initial positivity for GADA, IA-2, and IAA or a combination of GADA and IAA.
Journal title abbreviation:: Pediatr Diabetes
Year:: 2014
Journal volume:: 15
Journal issue:: 2
Pages contribution:: 118-26
Language:: eng
Fulltext / DOI:: doi:10.1111/pedi.12066
Pubmed ID:: http://view.ncbi.nlm.nih.gov/pubmed/24034790
Print-ISSN:: 1399-543X
TUM Institution:: Klinik und Poliklinik für Kinderheilkunde und Jugendmedizin
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mediaTUM Gesamtbestand Einrichtungen Schools TUM School of Medicine and Health Departments Clinical Medicine Klinik und Poliklinik für Kinder- und Jugendmedizin (Prof. Hauer)2014