Dataset Information

A new approach for diagnosing type 1 diabetes in autoantibody-positive individuals based on prediction and natural history.

ABSTRACT:

Objective

We assessed whether type 1 diabetes (T1D) can be diagnosed earlier using a new approach based on prediction and natural history in autoantibody-positive individuals.

Research design and methods

Diabetes Prevention Trial-Type 1 (DPT-1) and TrialNet Natural History Study (TNNHS) participants were studied. A metabolic index, the T1D Diagnostic Index60 (Index60), was developed from 2-h oral glucose tolerance tests (OGTTs) using the log fasting C-peptide, 60-min C-peptide, and 60-min glucose. OGTTs with Index60 ?2.00 and 2-h glucose <200 mg/dL (Ind60+Only) were compared with Index60 <2.00 and 2-h glucose ?200 mg/dL (2hglu+Only) OGTTs as criteria for T1D. Individuals were assessed for C-peptide loss from the first Ind60+Only OGTT to diagnosis.

Results

Areas under receiver operating characteristic curves were significantly higher for Index60 than for the 2-h glucose (P < 0.001 for both DPT-1 and the TNNHS). As a diagnostic criterion, sensitivity was higher for Ind60+Only than for 2hglu+Only (0.44 vs. 0.15 in DPT-1; 0.26 vs. 0.17 in the TNNHS) OGTTs. Specificity was somewhat higher for 2hglu+Only OGTTs in DPT-1 (0.97 vs. 0.91) but equivalent in the TNNHS (0.98 for both). Positive and negative predictive values were higher for Ind60+Only OGTTs in both studies. Postchallenge C-peptide levels declined significantly at each OGTT time point from the first Ind60+Only OGTT to the time of standard diagnosis (range -22 to -34% in DPT-1 and -14 to -27% in the TNNHS). C-peptide and glucose patterns differed markedly between Ind60+Only and 2hglu+Only OGTTs.

Conclusions

An approach based on prediction and natural history appears to have utility for diagnosing T1D.

SUBMITTER: Sosenko JM

PROVIDER: S-EPMC4302258 | biostudies-literature | 2015 Feb

REPOSITORIES: biostudies-literature

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Publications

A new approach for diagnosing type 1 diabetes in autoantibody-positive individuals based on prediction and natural history.

Sosenko Jay M JM Skyler Jay S JS DiMeglio Linda A LA Beam Craig A CA Krischer Jeffrey P JP Greenbaum Carla J CJ Boulware David D Rafkin Lisa E LE Matheson Della D Herold Kevan C KC Mahon Jeffrey J Palmer Jerry P JP

Diabetes care 20141217 2

<h4>Objective</h4>We assessed whether type 1 diabetes (T1D) can be diagnosed earlier using a new approach based on prediction and natural history in autoantibody-positive individuals.<h4>Research design and methods</h4>Diabetes Prevention Trial-Type 1 (DPT-1) and TrialNet Natural History Study (TNNHS) participants were studied. A metabolic index, the T1D Diagnostic Index60 (Index60), was developed from 2-h oral glucose tolerance tests (OGTTs) using the log fasting C-peptide, 60-min C-peptide, an ...[more]

PMID: 25519451

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Dataset Information

A new approach for diagnosing type 1 diabetes in autoantibody-positive individuals based on prediction and natural history.

Objective

Research design and methods

Results

Conclusions

Publications

A new approach for diagnosing type 1 diabetes in autoantibody-positive individuals based on prediction and natural history.

Similar Datasets

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