Risk of T1DM up in children with autoantibody reversion

(HealthDay)—The risk of type 1 diabetes remains elevated for children who have developed multiple β-cell autoantibodies, even after reversion of individual autoantibodies, according to a study published online June 16 in Diabetes Care.

Kendra Vehik, M.P.H., Ph.D., from the University of South Florida in Tampa, and colleagues examined the frequency of β-cell autoantibody reversion in children at risk for type 1 diabetes. Children aged up to 10 years who were screened more than once for insulin autoantibody, GAD antibody, and insulinoma antigen-2 antibodies were included. Reversion was defined as two or more negative visits after persistence, which was defined as autoantibody present on two or more consecutive visits and confirmed in two reference laboratories.

The researchers found that reversion was 19 and 29 percent for autoantibodies to GAD65 and insulin, respectively, and was mainly seen in children with single autoantibodies (24 percent), and rarely seen in those with multiple autoantibodies (<1 percent). Eight-five percent of reversions of single autoantibodies were observed within two years of seroconversion. There were correlations for reversion with human leukocyte antigen genotype, age, and decreasing titer. The risk for type 1 diabetes was 0.14, 0.06, and 1.8 per 100 person-years for those who reverted from single autoantibodies to autoantibody negative, those who never developed autoantibodies, and those who remained single-autoantibody positive, respectively.

"Monitoring children with single autoantibodies for at least one year after seroconversion is beneficial for stratification of type 1 diabetes risk," the authors write.

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