Type 1 Diabetes Genetic Risk in 109,954 Veterans With Adult-Onset Diabetes: The Million Veteran Program (MVP)
Authors' conclusion
Characteristics associated with T1D were increased with higher genetic risk, and especially with the top 10% of risk. However, the age and BMI of those participants resemble those of people with T2D, and a substantial proportion did not have diagnostic testing or use of T1D diagnostic codes. T1D genetic screening could be used to aid identification of adult-onset T1D in settings in which T2D predominates.
Study context
- Population
- Million Veteran Program participants with adult-onset diabetes and T1D genetic risk scores (GRS), 2011–2021
- Participants
- 109,594 participants
- Exposure
- T1D GRS categories: highest vs low
- Outcome
- Characteristics typically associated with T1D
Methodological detailsMillion Veteran Program, 2011-2021
- Million Veteran Program
- 2011-2021
Main finding
As reported in the abstract
T1D characteristics across genetic risk categories
- T1D characteristics increased progressively with higher genetic risk
- P < 0.001 for trend
Observational data: associations, not effects.
Further findings
| Outcome | Low | Highest | P value |
|---|---|---|---|
| DKAHighest vs Low · more likely with Highest | 0.9% | 3.7% | P < 0.001 |
| Hypoglycemia prompting emergency visitsHighest vs Low · more likely with Highest | 3.7% | 5.8% | P < 0.001 |
| Outpatient plasma glucose <50 mg/dLHighest vs Low · more likely with Highest | 7.5% | 13.4% | P < 0.001 |
| Time to start insulinHighest vs Low · shorter with Highest · median, years | 3.5 | 1.4 | P < 0.001 |
| Use of a T1D diagnostic codeHighest vs Low · more likely with Highest | 16.3% | 28.1% | P < 0.001 |
| Low C-peptide levels if testedHighest vs Low · more likely with Highest | 1.8% | 32.4% | P < 0.001 |
| GADAHighest vs Low · more likely with Highest | 6.9% | 45.2% | P < 0.001 |
GRS ≥90%: age at diagnosis and characteristics
- GRS ≥90% more common with diagnosis before age 40 y; share diagnosed at age ≥40 y
- 95%
- Mean age, GRS ≥90%
- 64.3 years
- BMI, GRS ≥90%
- 32.3 kg/m²
- Characteristics resembled those of individuals with T2D
Original publication
Type 1 Diabetes Genetic Risk in 109,954 Veterans With Adult-Onset Diabetes: The Million Veteran Program (MVP). Diabetes Care. Published 12 April 2024. doi:10.
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