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Relationship between islet autoantibody status and the clinical characteristics of children and adults with incident type 1 diabetes in a UK cohort

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Relationship between islet autoantibody status and the clinical characteristics of children and adults with incident type 1 diabetes in a UK cohort. / Bravis, Vassiliki; Kaur, Akaal; Walkey, Helen C; Godsland, Ian F; Misra, Shivani; Bingley, Polly J; Williams, Alistair J K; Dunger, David B; Dayan, Colin M; Peakman, Mark; Oliver, Nick S; Johnston, Desmond G; ADDRESS-2 Management Committee, Patient Advocate Group and Investigators.

In: BMJ Open, Vol. 8, No. 4, 04.04.2018, p. e020904.

Research output: Contribution to journalArticle

Harvard

Bravis, V, Kaur, A, Walkey, HC, Godsland, IF, Misra, S, Bingley, PJ, Williams, AJK, Dunger, DB, Dayan, CM, Peakman, M, Oliver, NS, Johnston, DG & ADDRESS-2 Management Committee, Patient Advocate Group and Investigators 2018, 'Relationship between islet autoantibody status and the clinical characteristics of children and adults with incident type 1 diabetes in a UK cohort', BMJ Open, vol. 8, no. 4, pp. e020904. https://doi.org/10.1136/bmjopen-2017-020904

APA

Bravis, V., Kaur, A., Walkey, H. C., Godsland, I. F., Misra, S., Bingley, P. J., ... ADDRESS-2 Management Committee, Patient Advocate Group and Investigators (2018). Relationship between islet autoantibody status and the clinical characteristics of children and adults with incident type 1 diabetes in a UK cohort. BMJ Open, 8(4), e020904. https://doi.org/10.1136/bmjopen-2017-020904

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Bravis, Vassiliki ; Kaur, Akaal ; Walkey, Helen C ; Godsland, Ian F ; Misra, Shivani ; Bingley, Polly J ; Williams, Alistair J K ; Dunger, David B ; Dayan, Colin M ; Peakman, Mark ; Oliver, Nick S ; Johnston, Desmond G ; ADDRESS-2 Management Committee, Patient Advocate Group and Investigators. / Relationship between islet autoantibody status and the clinical characteristics of children and adults with incident type 1 diabetes in a UK cohort. In: BMJ Open. 2018 ; Vol. 8, No. 4. pp. e020904.

Bibtex

@article{d19c6a512346462688f088ebfdb25d16,
title = "Relationship between islet autoantibody status and the clinical characteristics of children and adults with incident type 1 diabetes in a UK cohort",
abstract = "OBJECTIVES: To describe the characteristics of children and adults with incident type 1 diabetes in contemporary, multiethnic UK, focusing on differences between the islet autoantibody negative and positive.DESIGN: Observational cohort study.SETTING: 146 mainly secondary care centres across England and Wales.PARTICIPANTS: 3312 people aged ≥5 years were recruited within 6 months of a clinical diagnosis of type 1 diabetes via the National Institute for Health Research Clinical Research Network. 3021 were of white European ethnicity and 291 (9{\%}) were non-white. There was a small male predominance (57{\%}). Young people <17 years comprised 59{\%}.MAIN OUTCOME MEASURES: Autoantibody status and characteristics at presentation.RESULTS: The majority presented with classical osmotic symptoms, weight loss and fatigue. Ketoacidosis was common (42{\%}), especially in adults, and irrespective of ethnicity. 35{\%} were overweight or obese. Of the 1778 participants who donated a blood sample, 85{\%} were positive for one or more autoantibodies against glutamate decarboxylase, islet antigen-2 and zinc transporter 8. Presenting symptoms were similar in the autoantibody-positive and autoantibody-negative participants, as was the frequency of ketoacidosis (43{\%}vs40{\%}, P=0.3). Autoantibody positivity was less common with increasing age (P=0.0001), in males compared with females (82{\%}vs90{\%}, P<0.0001) and in people of non-white compared with white ethnicity (73{\%}vs86{\%}, P<0.0001). Body mass index was higher in autoantibody-negative adults than autoantibody-positive adults (median, IQR 25.5, 23.1-29.2vs23.9, 21.4-26.7 kg/m2; P=0.0001). Autoantibody-negative participants were more likely to have a parent with diabetes (28{\%}vs16{\%}, P<0.0001) and less likely to have another autoimmune disease (4{\%}vs8{\%}, P=0.01).CONCLUSIONS: Most people assigned a diagnosis of type 1 diabetes presented with classical clinical features and islet autoantibodies. Although indistinguishable at an individual level, autoantibody-negative participants as a group demonstrated features more typically associated with other diabetes subtypes.TRIAL REGISTRATION NUMBER: ISRCTN66496918; Pre-results.",
keywords = "Journal Article",
author = "Vassiliki Bravis and Akaal Kaur and Walkey, {Helen C} and Godsland, {Ian F} and Shivani Misra and Bingley, {Polly J} and Williams, {Alistair J K} and Dunger, {David B} and Dayan, {Colin M} and Mark Peakman and Oliver, {Nick S} and Johnston, {Desmond G} and {ADDRESS-2 Management Committee, Patient Advocate Group and Investigators}",
note = "{\circledC} Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.",
year = "2018",
month = "4",
day = "4",
doi = "10.1136/bmjopen-2017-020904",
language = "English",
volume = "8",
pages = "e020904",
journal = "BMJ Open",
issn = "2044-6055",
publisher = "BMJ Publishing Group",
number = "4",

}

RIS - suitable for import to EndNote

TY - JOUR

T1 - Relationship between islet autoantibody status and the clinical characteristics of children and adults with incident type 1 diabetes in a UK cohort

AU - Bravis, Vassiliki

AU - Kaur, Akaal

AU - Walkey, Helen C

AU - Godsland, Ian F

AU - Misra, Shivani

AU - Bingley, Polly J

AU - Williams, Alistair J K

AU - Dunger, David B

AU - Dayan, Colin M

AU - Peakman, Mark

AU - Oliver, Nick S

AU - Johnston, Desmond G

AU - ADDRESS-2 Management Committee, Patient Advocate Group and Investigators

N1 - © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

PY - 2018/4/4

Y1 - 2018/4/4

N2 - OBJECTIVES: To describe the characteristics of children and adults with incident type 1 diabetes in contemporary, multiethnic UK, focusing on differences between the islet autoantibody negative and positive.DESIGN: Observational cohort study.SETTING: 146 mainly secondary care centres across England and Wales.PARTICIPANTS: 3312 people aged ≥5 years were recruited within 6 months of a clinical diagnosis of type 1 diabetes via the National Institute for Health Research Clinical Research Network. 3021 were of white European ethnicity and 291 (9%) were non-white. There was a small male predominance (57%). Young people <17 years comprised 59%.MAIN OUTCOME MEASURES: Autoantibody status and characteristics at presentation.RESULTS: The majority presented with classical osmotic symptoms, weight loss and fatigue. Ketoacidosis was common (42%), especially in adults, and irrespective of ethnicity. 35% were overweight or obese. Of the 1778 participants who donated a blood sample, 85% were positive for one or more autoantibodies against glutamate decarboxylase, islet antigen-2 and zinc transporter 8. Presenting symptoms were similar in the autoantibody-positive and autoantibody-negative participants, as was the frequency of ketoacidosis (43%vs40%, P=0.3). Autoantibody positivity was less common with increasing age (P=0.0001), in males compared with females (82%vs90%, P<0.0001) and in people of non-white compared with white ethnicity (73%vs86%, P<0.0001). Body mass index was higher in autoantibody-negative adults than autoantibody-positive adults (median, IQR 25.5, 23.1-29.2vs23.9, 21.4-26.7 kg/m2; P=0.0001). Autoantibody-negative participants were more likely to have a parent with diabetes (28%vs16%, P<0.0001) and less likely to have another autoimmune disease (4%vs8%, P=0.01).CONCLUSIONS: Most people assigned a diagnosis of type 1 diabetes presented with classical clinical features and islet autoantibodies. Although indistinguishable at an individual level, autoantibody-negative participants as a group demonstrated features more typically associated with other diabetes subtypes.TRIAL REGISTRATION NUMBER: ISRCTN66496918; Pre-results.

AB - OBJECTIVES: To describe the characteristics of children and adults with incident type 1 diabetes in contemporary, multiethnic UK, focusing on differences between the islet autoantibody negative and positive.DESIGN: Observational cohort study.SETTING: 146 mainly secondary care centres across England and Wales.PARTICIPANTS: 3312 people aged ≥5 years were recruited within 6 months of a clinical diagnosis of type 1 diabetes via the National Institute for Health Research Clinical Research Network. 3021 were of white European ethnicity and 291 (9%) were non-white. There was a small male predominance (57%). Young people <17 years comprised 59%.MAIN OUTCOME MEASURES: Autoantibody status and characteristics at presentation.RESULTS: The majority presented with classical osmotic symptoms, weight loss and fatigue. Ketoacidosis was common (42%), especially in adults, and irrespective of ethnicity. 35% were overweight or obese. Of the 1778 participants who donated a blood sample, 85% were positive for one or more autoantibodies against glutamate decarboxylase, islet antigen-2 and zinc transporter 8. Presenting symptoms were similar in the autoantibody-positive and autoantibody-negative participants, as was the frequency of ketoacidosis (43%vs40%, P=0.3). Autoantibody positivity was less common with increasing age (P=0.0001), in males compared with females (82%vs90%, P<0.0001) and in people of non-white compared with white ethnicity (73%vs86%, P<0.0001). Body mass index was higher in autoantibody-negative adults than autoantibody-positive adults (median, IQR 25.5, 23.1-29.2vs23.9, 21.4-26.7 kg/m2; P=0.0001). Autoantibody-negative participants were more likely to have a parent with diabetes (28%vs16%, P<0.0001) and less likely to have another autoimmune disease (4%vs8%, P=0.01).CONCLUSIONS: Most people assigned a diagnosis of type 1 diabetes presented with classical clinical features and islet autoantibodies. Although indistinguishable at an individual level, autoantibody-negative participants as a group demonstrated features more typically associated with other diabetes subtypes.TRIAL REGISTRATION NUMBER: ISRCTN66496918; Pre-results.

KW - Journal Article

U2 - 10.1136/bmjopen-2017-020904

DO - 10.1136/bmjopen-2017-020904

M3 - Article

VL - 8

SP - e020904

JO - BMJ Open

JF - BMJ Open

SN - 2044-6055

IS - 4

ER -