Refining the Definition of Stage 1 Type 1 Diabetes: An Ontology-Driven Analysis of the Heterogeneity of Multiple Islet Autoimmunity
Authors' conclusion
The 15-year risk of progression to type 1 diabetes risk varies markedly from 18 to 88% based on the stringency of mIA definition. While initial categorization identifies highest-risk individuals, short-term follow-up over 2 years may help stratify evolving risk, especially for those with less stringent definitions of mIA.
Study context
- Population
- Children with increased genetic risk for T1D from Finland, Germany, Sweden and the U.S. (T1DI), enrolled by age 2.5 years865 with mIA
- Participants
- 16,709 children
- Exposure
- Varying definitions of multiple islet autoantibody positivity
- Outcome
- Progression to stage 3 T1D
- Follow-up
- 15-year cumulative incidence
Methodological detailscombined prospective data set, multinational, Kaplan-Meier survival analysis
- Combined prospective data set
- Multinational
- Kaplan-Meier survival analysis
Main finding
As reported in the abstract
Cumulative incidence of diabetes · 15 years
mIA/Persistent/2 vs all other groups: P < 0.0001 · Intermediate stringency definitions vs mIA/Any: P < 0.05
Observational data: associations, not effects.
Further findings
Progression among children with mIA
- Children with mIA
- 865 (5%)
- Progressed to T1D
- 537 (62%)
Loss of one autoantibody in mIA/Persistent/2 with three autoantibodies · 2-year follow-up
- Loss of one autoantibody associated with accelerated progression
Age
- Age significantly associated with time from seroconversion to mIA/Persistent/2 and from mIA to stage 3 T1D
Original publication
Refining the Definition of Stage 1 Type 1 Diabetes: An Ontology-Driven Analysis of the Heterogeneity of Multiple Islet Autoimmunity. Diabetes Care. Published 2 March 2023. doi:10.
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