What Have Slow Progressors Taught Us About T1D-Mind the Gap!

Curr Diab Rep 2019 Sep 10;19(10):99. Epub 2019 Sep 10.

Diabetes and Metabolism, Bristol Medical School, University of Bristol, Level 2, Learning and Research, Southmead Hospital, Bristol, BS10 5NB, UK.

Purpose Of Review: Progression rate from islet autoimmunity to clinical diabetes is unpredictable. In this review, we focus on an intriguing group of slow progressors who have high-risk islet autoantibody profiles but some remain diabetes free for decades.

Recent Findings: Birth cohort studies show that islet autoimmunity presents early in life and approximately 70% of individuals with multiple islet autoantibodies develop clinical symptoms of diabetes within 10 years. Some "at risk" individuals however progress very slowly. Recent genetic studies confirm that approximately half of type 1 diabetes (T1D) is diagnosed in adulthood. This creates a conundrum; slow progressors cannot account for the number of cases diagnosed in the adult population. There is a large "gap" in our understanding of the pathogenesis of adult onset T1D and a need for longitudinal studies to determine whether there are "at risk" adults in the general population; some of whom are rapid and some slow adult progressors.

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Source
http://dx.doi.org/10.1007/s11892-019-1219-1DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6733826PMC
September 2019

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