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Elding Larsson, H.* ; Vehik, K.* ; Gesualdo, P.* ; Akolkar, B.* ; Hagopian, W.* ; Krischer, J.P.* ; Lernmark, A.* ; Rewers, M.* ; Simell, O.* ; She, J.-X.* ; Ziegler, A.-G. ; Haller, M.J.* ; TEDDY Study Group (Beyerlein, A. ; Bonifacio, E. ; Hummel, M. ; Hummel, S. ; Foterek, K. ; Kersting, M. ; Knopff, A. ; Koletzko, S. ; Peplow, C. ; Roth, R. ; Stock, J. ; Strauss, E. ; Warncke, K. ; Winkler, C.)

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

Pediatr. Diabetes 15, 118-126 (2014)
DOI
Open Access Green as soon as Postprint is submitted to ZB.
Objective: 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. Methods: Autoantibodies to glutamic acid decarboxylase (GADA), insulinoma-associated protein 2 (IA-2) and insulin (IAA) were analyzed from 3months of age in children with genetic risk. Symptoms and laboratory values at diagnosis were obtained and reviewed for ADA criteria. Results: The first 100 children to develop T1D, 33 first-degree relatives (FDRs), with a median age 2.3yr (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 3yr of age but only 4/70 (5.7%) below the age of 3yr. 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). Conclusions: 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.
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Publication type Article: Journal article
Document type Scientific Article
Keywords Autoantibodies ; Diagnosis ; Follow-up Studies ; Teddy Study ; Type 1 Diabetes; Glutamic-acid Decarboxylase; Young-children; Environmental Determinants; Islet Antigen-2; Ketoacidosis; Risk; Mellitus; Onset; Autoantibodies; Adolescents
ISSN (print) / ISBN 1399-543X
e-ISSN 1399-5448
Journal Pediatric Diabetes
Quellenangaben Volume: 15, Issue: 2, Pages: 118-126 Article Number: , Supplement: ,
Publisher Wiley
Publishing Place Hoboken
Reviewing status Peer reviewed
Institute(s) Institute of Diabetes Research (IDF)
Institute of Diabetes and Obesity (IDO)
Institute of Pancreatic Islet Research (IPI)