Evidence map›Paper›PMID 31768570›Full record

ArticleDiabetologia2020

The risk of progression to type 1 diabetes is highly variable in individuals with multiple autoantibodies following screening.

Laura M Jacobsen, Laura Bocchino, Carmella Evans-Molina, Linda DiMeglio, Robin Goland, Darrell M Wilson, Mark A Atkinson, Tandy Aye, William E Russell, John M Wentworth and 3 more

Registry-linked trialOpen access · bronzeAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Diabetologia, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06006468 (Evaluating ImmuNe Changes in the Evolution of Pre Type 1 Diabetes With Adult Onset), which is not on this map. Cited by 88 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
88citing papers in PubMed, 2 pooled it
5.9field-weighted citation impact, top 3% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT06006468 completednot on this mapstarted 2023, after this paper: background citation

Evaluating ImmuNe Changes in the Evolution of Pre Type 1 Diabetes With Adult Onset

TypeobservationalSponsorRoyal Devon and Exeter NHS Foundation TrustRan2023 to 2023Enrolled2,250ConditionsType 1 Diabetes, Type 1 Diabetes Mellitus Maturity OnsetArmsHigh genetic risk for type 1 diabetes, High gentic risk for Coeliac disease
3 · Its place in the literature

Who cites it

88 citing papers in PubMed, 2 syntheses or guidelines pooled it, 118 citations in OpenAlex.

  1. Pooled it
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  7. Type 1 Diabetes Mellitus Pathogenesis: Mechanisms, Early Diagnostic Strategies, and Emerging Therapeutic Approaches.Pathophysiology : the official journal of the International Society for Pathophysiology · 2026
    Review
  8. New and emerging therapies in type 1 diabetes mellitus.The Journal of clinical investigation · 2026
    Review
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28 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors at 8 institutions in 2 countries.

Laura M JacobsenDivision of Pediatric Endocrinology, Department of Pediatrics, College of Medicine, University of Florida, 1275 Center Drive, Gainesville, FL, 32610, USA. lauraj@ufl.edu.ORCID 0000-0002-5144-7836
Laura BocchinoHealth Informatics Institute, University of South Florida, Tampa, FL, USA.
Carmella Evans-MolinaCenter for Diabetes and Metabolic Diseases, Indiana University School of Medicine, Indianapolis, IN, USA.
Linda DiMeglioCenter for Diabetes and Metabolic Diseases, Indiana University School of Medicine, Indianapolis, IN, USA.
Robin GolandDivision of Pediatric Endocrinology, Diabetes, and Metabolism, Columbia University Medical Center, New York, NY, USA.
Darrell M WilsonDepartment of Pediatrics, Stanford University School of Medicine, Stanford, CA, USA.
Mark A AtkinsonDepartment of Pathology, Immunology and Laboratory Medicine, University of Florida College of Medicine, Gainesville, FL, USA.
Tandy AyeDepartment of Pediatrics, Stanford University School of Medicine, Stanford, CA, USA.
William E RussellDepartment of Pediatrics, Vanderbilt University Medical Center, Nashville, TN, USA.
John M WentworthWalter and Eliza Hall Institute, Parkville, VIC, Australia.
David BoulwareHealth Informatics Institute, University of South Florida, Tampa, FL, USA.
Susan GeyerHealth Informatics Institute, University of South Florida, Tampa, FL, USA.
Jay M SosenkoDivision of Endocrinology, University of Miami, Miami, FL, USA.
University of South Florida · USIndiana University School of MedicineStanford University · USUniversity of Florida · USColumbia University Irving Medical Center · USThe Royal Melbourne Hospital · AUUniversity of Miami · USVanderbilt University Medical Center · US

Funding

Revision to the Coordinating Center for Type 1 Diabetes TrialNetU01DK106993 · NIDDK · UNIVERSITY OF SOUTH FLORIDA · PI JEFFREY P KRISCHER, SAMUEL S WU · 2019 to 2026
$181.3M
NIDDK Type 1 Diabetes TrialNet Data Coordinating CenterUC4DK106993 · NIDDK · UNIVERSITY OF SOUTH FLORIDA · PI KRISCHER, JEFFREY P · 2015 to 2015
$36.6M
Project 3P01AI042288 · NIAID · UNIVERSITY OF FLORIDA · PI Todd Michael Brusko · 1997 to 2026
$32.9M
Translation CoreP30DK097512 · NIDDK · INDIANA UNIVERSITY INDIANAPOLIS · PI Carmella Evans-Molina · 2015 to 2026
$17.4M
Type 1 Diabetes TrialNet Clinical Network HubU01DK103282 · NIDDK · BENAROYA RESEARCH INST AT VIRGINIA MASON · PI CARLA J GREENBAUM, KURT J GRIFFIN · 2014 to 2026
$14.2M
Northwest Clinical Center for Type 1 Diabetes - TrialNetU01DK061034 · NIDDK · BENAROYA RESEARCH INST AT VIRGINIA MASON · PI GREENBAUM, CARLA J · 2001 to 2018
$10.3M
Type I Diabetes Trialnet at StsnfordU01DK061042 · NIDDK · STANFORD UNIVERSITY · PI WILSON, DARRELL M · 2001 to 2018
$8.5M
UCSF Trialnet: A Phase II Trial of Imatimib in New Onset Type I DiabetesU01DK061010 · NIDDK · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI GITELMAN, STEPHEN E · 2001 to 2018
$8.1M
Type 1 Diabetes-A Proposal for Prevention & InterventionU01DK085476 · NIDDK · UNIVERSITY OF MINNESOTA · PI MORAN, ANTOINETTE M. · 2009 to 2018
$7.1M
Prediction and Prevention of Type I DiabetesU01DK061058 · NIDDK · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · PI BECKER, DOROTHY J · 2001 to 2018
$6.5M
TrialNet: University of Florida Clinical Center and NetworkU01DK085461 · NIDDK · UNIVERSITY OF FLORIDA · PI HALLER, MICHAEL JAMES · 2009 to 2018
$5.9M
TrialNet: Diabetes Type 1 PreventionU01DK085509 · NIDDK · UNIVERSITY OF COLORADO DENVER · PI GOTTLIEB, PETER A · 2009 to 2018
$5.8M
NIAID NIH HHS P01 AI042288NIDDK NIH HHS P30 DK097512NIDDK NIH HHS R01 DK093954NIDDK NIH HHS U01 DK061010NIDDK NIH HHS U01 DK061034NIDDK NIH HHS U01 DK061042NIDDK NIH HHS U01 DK061058NIDDK NIH HHS U01 DK085453NIDDK NIH HHS U01 DK085461NIDDK NIH HHS U01 DK085465NIDDK NIH HHS U01 DK085466NIDDK NIH HHS U01 DK085476NIDDK NIH HHS U01 DK085499NIDDK NIH HHS U01 DK085504NIDDK NIH HHS U01 DK085509NIDDK NIH HHS U01 DK103153NIDDK NIH HHS U01 DK103180NIDDK NIH HHS U01 DK103266NIDDK NIH HHS U01 DK103282NIDDK NIH HHS U01 DK106984NIDDK NIH HHS U01 DK106993NIDDK NIH HHS U01 DK106994NIDDK NIH HHS U01 DK107013NIDDK NIH HHS U01 DK107014NIDDK NIH HHS UC4 DK106993TrialNet is supported by NIH and JDRF U01 DK107013, U01 DK107014, UC4 DK106993, JDRF
6 · The paper itself

Abstract

aims/hypothesisYoung children who develop multiple autoantibodies (mAbs) are at very high risk for type 1 diabetes. We assessed whether a population with mAbs detected by screening is also at very high risk, and how risk varies according to age, type of autoantibodies and metabolic status.

methodsType 1 Diabetes TrialNet Pathway to Prevention participants with mAbs (n = 1815; age, 12.35 ± 9.39 years; range, 1-49 years) were analysed. Type 1 diabetes risk was assessed according to age, autoantibody type/number (insulin autoantibodies [IAA], glutamic acid decarboxylase autoantibodies [GADA], insulinoma-associated antigen-2 autoantibodies [IA-2A] or zinc transporter 8 autoantibodies [ZnT8A]) and Index60 (composite measure of fasting C-peptide, 60 min glucose and 60 min C-peptide). Cox regression and cumulative incidence curves were utilised in this cohort study.

resultsAge was inversely related to type 1 diabetes risk in those with mAbs (HR 0.97 [95% CI 0.96, 0.99]). Among participants with 2 autoantibodies, those with GADA had less risk (HR 0.35 [95% CI 0.22, 0.57]) and those with IA-2A had higher risk (HR 2.82 [95% CI 1.76, 4.51]) of type 1 diabetes. Those with IAA and GADA had only a 17% 5 year risk of type 1 diabetes. The risk was significantly lower for those with Index60 <1.0 (HR 0.23 [95% CI 0.19, 0.30]) vs those with Index60 values ≥1.0. Among the 12% (225/1815) ≥12.0 years of age with GADA positivity, IA-2A negativity and Index60 <1.0, the 5 year risk of type 1 diabetes was 8%. CONCLUSIONS/

interpretationType 1 diabetes risk varies substantially according to age, autoantibody type and metabolic status in individuals screened for mAbs. An appreciable proportion of older children and adults with mAbs appear to have a low risk of progressing to type 1 diabetes at 5 years. With this knowledge, clinical trials of type 1 diabetes prevention can better target those most likely to progress.

Indexed as

AdolescentAdultAutoantibodiesAutoimmune DiseasesChildChild, PreschoolCohort StudiesDiabetes Mellitus, Type 1Disease ProgressionFemaleFollow-Up StudiesGenetic Predisposition to DiseaseGlucose Tolerance TestHumansIndividualityInfantAutoantibodiesAgeAutoantibodiesIndex60MetabolicType 1 diabetes

Identifiers

PMID31768570
PMCPMC7229995
OpenAlexW2989794873

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.