ArticleDiabetes care2021
Islet Autoimmunity and HLA Markers of Presymptomatic and Clinical Type 1 Diabetes: Joint Analyses of Prospective Cohort Studies in Finland, Germany, Sweden, and the U.S.
Article in Diabetes care, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 45 papers, 3 of them syntheses that pooled it.
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Who cites it
45 citing papers in PubMed, 3 syntheses or guidelines pooled it, 71 citations in OpenAlex.
- Polish Recommendations for the Early Detection of Type 1 Diabetes in the Pediatric Population: A Position Statement of the Polish Society of Pediatric Endocrinology and Diabetology and the Pediatric Section of the Diabetes Poland 2026.Hormone research in paediatrics · 2026Guideline
- UK best practice recommendations for children and young people <18 years with pre-stage 3 type 1 diabetes, on behalf of the British Society for Paediatric Endocrinology and Diabetes (BSPED).Diabetic medicine : a journal of the British Diabetic Association · 2025Guideline
- ISPAD Clinical Practice Consensus Guidelines 2024: Screening, Staging, and Strategies to Preserve Beta-Cell Function in Children and Adolescents with Type 1 Diabetes.Hormone research in paediatrics · 2024Guideline
- Long-Term Follow-Up Incidence of Type 1 Diabetes and Associated Autoimmune Diseases in First-Degree Relatives.Diabetes, obesity & metabolism · 2026Article
- Oxidative Stress Biomarkers in Pediatric and Early-Stage Type 1 Diabetes: Toward Redox Phenotyping.Antioxidants (Basel, Switzerland) · 2026Review
- The First Selective Screening for Type 1 Diabetes in a Pediatric Population in Bulgaria.Journal of clinical medicine · 2026Article
- The inflammatory path toward type 1 diabetes begins during pregnancy.Nature communications · 2026Article
- Single-cell RNA-seq analysis of longitudinal CD4Genome medicine · 2025Article
- Development of a novel flow cytometry multiplex immunoassay for the diagnosis of celiac disease simultaneously with autoimmune diabetes.European journal of medical research · 2025Article
- Optimizing Type 1 Diabetes Screening in People With Family History: A German Perspective.Journal of diabetes science and technology · 2025Review
- Article
- Teplizumab for stage 2 type 1 diabetes: a new era in pediatric diabetes prevention.European journal of pediatrics · 2025Review
- Persisting plasma proinsulin levels in a cohort of 482 individuals with long-standing type 1 diabetes mellitus.Diabetes, obesity & metabolism · 2025Article
- β-Cell Function and Glucose Tolerance in Persons With Multiple Islet Autoantibodies Randomized to a Gluten-free Diet.Journal of the Endocrine Society · 2025Article
- Health economic considerations of screening for early type 1 diabetes.Diabetes, obesity & metabolism · 2025Review
- Protocol for the development of a core outcome set for type 1 diabetes risk screening.BMJ open · 2025Article
- Novel T-Cell Reactivities to Hybrid Insulin Peptides in Islet Autoantibody-Positive At-Risk Individuals.Diabetes · 2025Article
- Emerging Concepts and Success Stories in Type 1 Diabetes Research: A Road Map for a Bright Future.Diabetes · 2025Article
- Type 1 diabetes: immune pathology and novel therapeutic approaches.Diabetology international · 2024Review
- Presentation and characteristics of children with screen-detected type 1 diabetes: learnings from the ELSA general population pediatric screening study.BMJ open diabetes research & care · 2024Article
Corrections and comments
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Authors and funding
20 authors at 10 institutions in 5 countries.
Funding
Abstract
objectiveTo combine prospective cohort studies, by including HLA harmonization, and estimate risk of islet autoimmunity and progression to clinical diabetes. RESEARCH DESIGN AND
methodsFor prospective cohorts in Finland, Germany, Sweden, and the U.S., 24,662 children at increased genetic risk for development of islet autoantibodies and type 1 diabetes have been followed. Following harmonization, the outcomes were analyzed in 16,709 infants-toddlers enrolled by age 2.5 years.
resultsIn the infant-toddler cohort, 1,413 (8.5%) developed at least one autoantibody confirmed at two or more consecutive visits (seroconversion), 865 (5%) developed multiple autoantibodies, and 655 (4%) progressed to diabetes. The 15-year cumulative incidence of diabetes varied in children with one, two, or three autoantibodies at seroconversion: 45% (95% CI 40-52), 85% (78-90), and 92% (85-97), respectively. Among those with a single autoantibody, status 2 years after seroconversion predicted diabetes risk: 12% (10-25) if reverting to autoantibody negative, 30% (20-40) if retaining a single autoantibody, and 82% (80-95) if developing multiple autoantibodies. HLA-DR-DQ affected the risk of confirmed seroconversion and progression to diabetes in children with stable single-autoantibody status. Their 15-year diabetes incidence for higher- versus lower-risk genotypes was 40% (28-50) vs. 12% (5-38). The rate of progression to diabetes was inversely related to age at development of multiple autoantibodies, ranging from 20% per year to 6% per year in children developing multipositivity in ≤2 years or >7.4 years, respectively.
conclusionsThe number of islet autoantibodies at seroconversion reliably predicts 15-year type 1 diabetes risk. In children retaining a single autoantibody, HLA-DR-DQ genotypes can further refine risk of progression.
Identifiers
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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.