Age of Diagnosis Does Not Alter the Presentation or Progression of Robustly Defined Adult-Onset Type 1 Diabetes
Authors' conclusion
When adult-onset T1D is robustly defined, the presentation characteristics, progression, and T1D genetic susceptibility are not altered by age of diagnosis.
Study context
- Population
- Adults with new-onset diabetes and confirmed T1D: ≥2 positive islet autoantibodies irrespective of clinical diagnosis (n = 385) or 1 positive islet autoantibody plus clinical diagnosis of T1D (n = 180)
- Participants
- 1,798 new-onset diabetes
- Exposure
- Diagnosis before vs after 35 years of age
- Outcome
- C-peptide loss (annual change in urine C-peptide-creatinine ratio [UCPCR])
Methodological detailsStartRight study
- StartRight study
Main finding
As reported in the abstract
Mean annual C-peptide loss, T1D defined by ≥2 positive islet autoantibodies
P > 0.1
- In continuous analysis, age of diagnosis not associated with C-peptide loss for either T1D definition
- P > 0.1
Observational data: associations, not effects.
Further findings
Presentation glucose, T1D defined by ≥2 autoantibodies
P ≥ 0.1
| Outcome | Diagnosed <35 years | Diagnosed >35 years | P value |
|---|---|---|---|
| Mean annual C-peptide loss, T1D defined by clinician diagnosis confirmed by 1 positive islet autoantibody | 43% (95% CI 33–51) | 39% (95% CI 31–46) | P > 0.1 |
| Unintentional weight loss at presentation, T1D defined by ≥2 autoantibodies | 80% (95% CI 74–85) | 82% (95% CI 76–87) | P ≥ 0.1 |
| Ketoacidosis at presentation, T1D defined by ≥2 autoantibodies | 24% (95% CI 18–30) | 19% (95% CI 14–25) | P ≥ 0.1 |
Baseline C-peptide and T1D GRS
- Unaffected by age of diagnosis or T1D definition
- P > 0.1
Diagnosis, treatment and hospital admission
- Despite similar presentation, older adults less likely to be diagnosed with T1D, insulin-treated, or admitted to hospital
Original publication
Age of Diagnosis Does Not Alter the Presentation or Progression of Robustly Defined Adult-Onset Type 1 Diabetes. Diabetes Care. Published 21 February 2023. doi:10.
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