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For most patients, experiencing several weeks of polyuria, polydipsia, fatigue, and significant weight loss may indicate the presence of diabetes. Furthermore, adults displaying the phenotypic appearance of type 2 diabetes (particularly those who are obese and not initially insulin-requiring), may have islet cell autoantibodies, suggesting autoimmune-mediated β cell destruction and a diagnosis of latent autoimmune diabetes of adults (LADA). The categorization of glucose homeostasis is...
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Predicting type 1 diabetes using biomarkers.

Ezio Bonifacio1

  • 1DFG-Center for Regenerative Therapies Dresden, and Faculty of Medicine, Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany; Paul Langerhans Institute Dresden of the Helmholtz Centre Munich at University Clinic Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany; German Center for Diabetes Research (DZD e.V.), Neuherberg, Germany; Forschergruppe Diabetes e.V., Neuherberg, Germany; and Institute of Diabetes and Obesity (IDO), Helmholtz Zentrum München, Neuherberg, Germany ezio.bonifacio@crt-dresden.de.

Diabetes Care
|May 23, 2015
PubMed
Summary
This summary is machine-generated.

Serum islet autoantibodies can diagnose asymptomatic type 1 diabetes, enabling early intervention. Future risk assessment will predict, stage, and prevent disease progression from birth using comprehensive biomarkers.

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Area of Science:

  • Immunology
  • Endocrinology
  • Biomarker Discovery

Background:

  • Clinical type 1 diabetes is preceded by an asymptomatic phase.
  • This phase is identifiable through serum islet autoantibodies.
  • Current disease management focuses on clinical presentation rather than early detection.

Purpose of the Study:

  • To advocate for the broader use of islet autoantibodies as diagnostic biomarkers for asymptomatic type 1 diabetes.
  • To propose a shift in disease management towards prevention of clinical hyperglycemia.
  • To outline a comprehensive risk assessment strategy for predicting, staging, and preventing type 1 diabetes.

Main Methods:

  • Review of existing evidence on islet autoantibodies as diagnostic markers.
  • Proposal for integrating genetic and metabolic biomarkers for risk prediction and staging.
  • Discussion of biomarkers needed for advanced disease prediction and prevention.

Main Results:

  • Sufficient evidence supports using islet autoantibodies for diagnosing asymptomatic type 1 diabetes.
  • A multi-stage risk assessment approach, starting at birth, is proposed.
  • This approach aims to predict, stage, and prevent disease initiation and progression.

Conclusions:

  • Islet autoantibodies are valuable biomarkers for early diagnosis of type 1 diabetes.
  • Comprehensive risk assessment using multiple biomarkers can enable proactive disease management.
  • Future strategies should focus on predicting and preventing type 1 diabetes from infancy.