Index60 Identifies Individuals at Appreciable Risk for Stage 3 Among an Autoantibody-Positive Population With Normal 2-Hour Glucose Levels: Implications for Current Staging Criteria of Type 1 Diabetes
dc.contributor.author | Nathan, Brandon M. | |
dc.contributor.author | Redondo, Maria J. | |
dc.contributor.author | Ismail, Heba | |
dc.contributor.author | Jacobsen, Laura | |
dc.contributor.author | Sims, Emily K. | |
dc.contributor.author | Palmer, Jerry | |
dc.contributor.author | Skyler, Jay | |
dc.contributor.author | Bocchino, Laura | |
dc.contributor.author | Geyer, Susan | |
dc.contributor.author | Sosenko, Jay M. | |
dc.contributor.department | Pediatrics, School of Medicine | |
dc.date.accessioned | 2023-10-31T14:39:14Z | |
dc.date.available | 2023-10-31T14:39:14Z | |
dc.date.issued | 2022 | |
dc.description.abstract | Objective: We assessed whether Index60, a composite measure of fasting C-peptide, 60-min C-peptide, and 60-min glucose, could improve the metabolic staging of type 1 diabetes for progression to clinical disease (stage 3) among autoantibody-positive (Ab+) individuals with normal 2-h glucose values (<140 mg/dL). Research design and methods: We analyzed 3,058 Type 1 Diabetes TrialNet Pathway to Prevention participants with 2-h glucose <140 mg/dL and Index60 <1.00 values from baseline oral glucose tolerance tests. Characteristics associated with type 1 diabetes (younger age, greater Ab+, higher HLA DR3-DQ2/DR4-DQ8 prevalence, and lower C-peptide) were compared among four mutually exclusive groups: top 2-h glucose quartile only (HI-2HGLU), top Index60 quartile only (HI-IND60), both top quartiles (HI-BOTH), and neither top quartile (LO-BOTH). Additionally, within the 2-h glucose distribution of <140 mg/dL and separately within the Index60 <1.00 distribution, comparisons were made between those above or below the medians. Results: HI-IND60 and HI-BOTH were younger, with greater frequency of more than two Ab+, and lower C-peptide levels, than either HI-2HGLU or LO-BOTH (all P < 0.001). The cumulative incidence for stage 3 was greater for HI-IND60 and HI-BOTH than for either HI-2HGLU or LO-BOTH (all P < 0.001). Those with Index60 values above the median were younger and had higher frequency of two or more Ab+ (P < 0.001) and DR3-DQ2/DR4-DQ8 prevalence (P < 0.001) and lower area under the curve (AUC) C-peptide levels (P < 0.001) than those below. Those above the 2-h glucose median had higher AUC C-peptide levels (P < 0.001), but otherwise did not differ from those below. Conclusions: Index60 identifies individuals with characteristics of type 1 diabetes at appreciable risk for progression who would otherwise be missed by 2-h glucose staging criteria. | |
dc.eprint.version | Final published version | |
dc.identifier.citation | Nathan BM, Redondo MJ, Ismail H, et al. Index60 Identifies Individuals at Appreciable Risk for Stage 3 Among an Autoantibody-Positive Population With Normal 2-Hour Glucose Levels: Implications for Current Staging Criteria of Type 1 Diabetes. Diabetes Care. 2022;45(2):311-318. doi:10.2337/dc21-0944 | |
dc.identifier.uri | https://hdl.handle.net/1805/36812 | |
dc.language.iso | en_US | |
dc.publisher | American Diabetes Association | |
dc.relation.isversionof | 10.2337/dc21-0944 | |
dc.relation.journal | Diabetes Care | |
dc.rights | Publisher Policy | |
dc.source | PMC | |
dc.subject | Autoantibodies | |
dc.subject | Blood glucose | |
dc.subject | Type 1 diabetes mellitus | |
dc.subject | Glucose tolerance test | |
dc.title | Index60 Identifies Individuals at Appreciable Risk for Stage 3 Among an Autoantibody-Positive Population With Normal 2-Hour Glucose Levels: Implications for Current Staging Criteria of Type 1 Diabetes | |
dc.type | Article |