Imperial College London
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Dr Shivani Misra

Faculty of Medicine, Department of Metabolism, Digestion and Reproduction

Clinical Senior Lecturer in Diabetes and Endocrinology
 
 
 
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Contact

 

s.misra

 
 
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Location

 

Commonwealth BuildingHammersmith Campus

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Summary

 

Publications

Citation

BibTex format

@article{Thomas:2021:10.1101/2021.03.22.21252507,
author = {Thomas, NJ and Walkey, HC and Kaur, A and Misra, S and Oliver, NS and Colclough, K and Weedon, MN and Johnston, DG and Hattersley, AT and Patel, KA},
doi = {10.1101/2021.03.22.21252507},
title = {The absence of islet autoantibodies in clinically diagnosed older-adult onset type 1 diabetes suggests an alternative pathology, advocating for routine testing in this age group},
url = {http://dx.doi.org/10.1101/2021.03.22.21252507},
year = {2021}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - <jats:title>Abstract</jats:title><jats:sec><jats:title>Objective</jats:title><jats:p>Islet autoantibodies at diagnosis are not well studied in older-adult onset (>30years) type 1 diabetes due to difficulties of accurate diagnosis. We used a type 1 diabetes genetic risk score (T1DGRS) to identify type 1 diabetes aiming to evaluate the prevalence and pattern of autoantibodies in older-adult onset type 1 diabetes.</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>We used a 30 variant T1DGRS in 1866 white-European individuals to genetically confirm a clinical diagnosis of new onset type 1 diabetes. We then assessed the prevalence and pattern of GADA, IA2A and ZnT8A within genetically consistent type 1 diabetes across three age groups (<18years (n=702), 18-30years (n=524) and >30years (n=588)).</jats:p></jats:sec><jats:sec><jats:title>Findings</jats:title><jats:p>In autoantibody positive cases T1DGRS was consistent with 100% type 1 diabetes in each age group. Conversely in autoantibody negative cases, T1DGRS was consistent with 93%(56/60) of <18years, 55%(37/67) of 18-30years and just 23%(34/151) of >30years having type 1 diabetes. Restricting analysis to genetically consistent type 1 diabetes showed similar proportions of positive autoantibodies across age groups (92% <18years, 92% 18-30years, 93% >30years)[p=0.87]. GADA was the most common autoantibody in older-adult onset type 1 diabetes, identifying 95% of autoantibody positive cases versus 72% in those <18years.</jats:p></jats:sec><jats:sec><jats:title>Interpretation</jats:title><jats:p>Older adult-onset type 1 diabetes has identical rates but different patterns of positive autoantibodies to childhood onset. In clinically suspected type 1 diabetes in older-adults, absence of autoantibodies strongly su
AU  - Thomas,NJ
AU  - Walkey,HC
AU  - Kaur,A
AU  - Misra,S
AU  - Oliver,NS
AU  - Colclough,K
AU  - Weedon,MN
AU  - Johnston,DG
AU  - Hattersley,AT
AU  - Patel,KA
DO  - 10.1101/2021.03.22.21252507
PY  - 2021///
TI  - The absence of islet autoantibodies in clinically diagnosed older-adult onset type 1 diabetes suggests an alternative pathology, advocating for routine testing in this age group
UR  - http://dx.doi.org/10.1101/2021.03.22.21252507
ER  -
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