TY - JOUR
T1 - What Have Slow Progressors Taught Us About T1D—Mind the Gap!
AU - Gillespie, Kathleen M.
AU - Long, Anna E.
PY - 2019/10/1
Y1 - 2019/10/1
N2 - 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. Summary: 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.
AB - 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. Summary: 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.
KW - Adult onset
KW - Islet autoantibodies
KW - Slow progression
KW - Type 1 diabetes (T1D)
UR - http://www.scopus.com/inward/record.url?scp=85071978240&partnerID=8YFLogxK
U2 - 10.1007/s11892-019-1219-1
DO - 10.1007/s11892-019-1219-1
M3 - Review article (Academic Journal)
C2 - 31501992
AN - SCOPUS:85071978240
VL - 19
JO - Current diabetes reports
JF - Current diabetes reports
SN - 1534-4827
M1 - 99
ER -