Islet autoimmunity in young First Nations women with prediabetes and type 2 diabetes

Type 1 diabetes in First Nations peoples is low yet type 2 diabetes is at epidemic proportions. This study aimed to determine the prevalence of islet autoimmunity in First Nations women with dysglycaemia and its association with clinical features.

One hundred and eighty First Nations women with prediabetes (n = 51) or type 2 diabetes (n = 129) were screened for any of GAD, IA-2 and ZnT8 autoantibodies using 3Screen ELISA, then ELISA for individual autoantibodies for positive screens. Associations between individual antibody positivity and clinical and metabolic characteristics were assessed.

Of the 180 women, 16% were positive on 3Screen, comprising 10/51 with prediabetes and 18/129 with diabetes. Sixteen of 28 positive on 3Screen were also positive for at least one individual autoantibody on ELISA testing; with 5/51 (10%) with prediabetes and 11/129 (9%) with diabetes. Individual autoantibody positivity was not associated with clinical and metabolic characteristics or markers of inflammation.

The proportion of individual autoantibody positivity among younger First Nations women with prediabetes or type 2 diabetes was 9%. Islet autoantibody positivity was not associated with a distinct clinical phenotype in this group. Longitudinal follow-up will allow assessment of glycaemic trajectories and clinical outcomes in younger First Nations women.