Molecular epidemiology of enteroviruses in young children at increased risk of type 1 diabetes

Objective: The pattern of the humoral immunity to disease-associated autoantigens may reflect the severity of the autoimmune disease process. The purpose of this study was to delineate the maturation of the humoral immunity to one of the main autoantigens in type 1 diabetes (T1D), glutamic acid decarboxylase (GAD65). Design and methods: Serum samples were obtained for the detection of epitope- and isotype-specific antibodies sequentially with short intervals from 36 young children with HLA-conferred genetic susceptibility to T1D starting from the first appearance of GAD65Ab. During prospective observation, ten children developed T1D. Antibodies were analyzed using biotinylated anti-human immunoglobulin (Ig) antibodies and chimeric GAD molecules in radio-binding assays. Results: The immune response to GAD65 started as reactivity to the middle region and spread rapidly to the C-terminal region. IgG1 antibodies dominated among the isotypes from the first appearance of GAD65Ab, while other IgG subclasses were observed to a lesser extent. IgG4 antibodies emerged clearly as the last IgG subclass. A broad initial response comprising three to four IgG subclasses and the lack of an emerging IgG4 response during follow-up was associated with increased risk for progression to clinical diabetes (P<0.05). Conclusions: The humoral response to GAD65 epitope clusters is relatively uniform in young children, whereas there is conspicuous individual variation in IgG subclass responses except for IgG1. A narrow initial IgG subclass response to GAD65 and the emergence of IgG4 antibodies were characteristic of those who remained non-diabetic over the first few years of GAD65 autoimmunity.

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Immune status is associated with the mode of delivery in infants at increased risk for Type 1 Diabetes

Diabetologie und Stoffwechsel ◽

10.1055/s-0034-1374887 ◽

2014 ◽

Vol 9 (S 01) ◽

Author(s):

O D'Orlando ◽

R Puff ◽

A Henniger ◽

S Krause ◽

F Haupt ◽

...

Keyword(s):

Type 1 Diabetes ◽

Immune Status ◽

Mode Of Delivery ◽

Increased Risk

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Use of diluted insulin in the management of very young children with type 1 diabetes: case report and literature review

Endocrine Abstracts ◽

10.1530/endoabs.58.p049 ◽

2018 ◽

Author(s):

A Emile J Hendriks ◽

Ross L Ewen ◽

Yoke Sin Hoh ◽

Nazia Bhatti ◽

Rachel M Williams ◽

...

Keyword(s):

Type 1 Diabetes ◽

Case Report ◽

Young Children ◽

Literature Review ◽

Diabetes Case ◽

Very Young Children

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Grazing in Young Children with Type 1 Diabetes Is Associated with Higher HbA1c

Diabetes ◽

10.2337/db18-1368-p ◽

2018 ◽

Vol 67 (Supplement 1) ◽

pp. 1368-P ◽

Cited By ~ 1

Author(s):

ROWEN L. SECKOLD ◽

PETER HOWLEY ◽

BRUCE R. KING ◽

KIRSTINE BELL ◽

CARMEL E. SMART

Keyword(s):

Type 1 Diabetes ◽

Young Children

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Metabolic Markers Associated with Increased Risk for Progression from Single to Multiple Autoantibodies in Type 1 Diabetes Relatives

Diabetes ◽

10.2337/db18-94-or ◽

2018 ◽

Vol 67 (Supplement 1) ◽

pp. 94-OR

Author(s):

EMANUELE BOSI ◽

SUSAN GEYER ◽

JAY SOSENKO ◽

DOROTHY J. BECKER ◽

MANUELA BATTAGLIA ◽

...

Keyword(s):

Type 1 Diabetes ◽

Metabolic Markers ◽

Increased Risk

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1278-P: Up All Night? Sleep in Parents of Young Children Newly Diagnosed with Type 1 Diabetes

Diabetes ◽

10.2337/db20-1278-p ◽

2020 ◽

Vol 69 (Supplement 1) ◽

pp. 1278-P

Author(s):

IMAN AL-GADI ◽

RANDI STREISAND ◽

MAUREEN MONAGHAN ◽

CARRIE TULLY ◽

MANUELA SINISTERRA ◽

...

Keyword(s):

Type 1 Diabetes ◽

Young Children ◽

Newly Diagnosed ◽

Night Sleep

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836-P: Cannabis Use in Adults with Type 1 Diabetes (T1D) Is Associated with Poor Glycemic Control and Increased Risk for Diabetic Ketoacidosis (DKA)

Diabetes ◽

10.2337/db19-836-p ◽

2019 ◽

Vol 68 (Supplement 1) ◽

pp. 836-P ◽

Cited By ~ 1

Author(s):

VIRAL N. SHAH ◽

DANIEL D. TAYLOR ◽

NICOLE C. FOSTER ◽

ROY BECK ◽

HALIS K. AKTURK ◽

...

Keyword(s):

Type 1 Diabetes ◽

Glycemic Control ◽

Diabetic Ketoacidosis ◽

Cannabis Use ◽

Poor Glycemic Control ◽

Increased Risk

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890-P: Durability of Continuous Glucose Monitoring (CGM) Use in Young Children, Teens, and Young Adults with Type 1 Diabetes (T1D)

Diabetes ◽

10.2337/db20-890-p ◽

2020 ◽

Vol 69 (Supplement 1) ◽

pp. 890-P

Author(s):

DANIEL DESALVO ◽

LAUREN KANAPKA ◽

COLLEEN BAUZA ◽

CICILYN XIE ◽

LINDA DIMEGLIO ◽

...

Keyword(s):

Type 1 Diabetes ◽

Young Adults ◽

Young Children ◽

Continuous Glucose Monitoring ◽

Glucose Monitoring

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Coeliac disease is associated with depression in children and young adults with type 1 diabetes: results from a multicentre diabetes registry

Acta Diabetologica ◽

10.1007/s00592-020-01649-8 ◽

2021 ◽

Author(s):

Sascha René Tittel ◽

◽

Désirée Dunstheimer ◽

Dörte Hilgard ◽

Burkhild Knauth ◽

...

Keyword(s):

Type 1 Diabetes ◽

Young Adults ◽

Coeliac Disease ◽

Diabetes Patient ◽

Routine Care ◽

Diabetes Registry ◽

Increased Risk ◽

Treatment Data ◽

Children And Young Adults

Abstract Aims To analyse the association between coeliac disease (CD) and depression in children, adolescents, and young adults with type 1 diabetes (T1D). Methods We included 79,067 T1D patients aged 6–20 years, with at least six months of diabetes duration, and treatment data between 1995 and 2019 were documented in the diabetes patient follow-up registry. We categorized patients into four groups: T1D only (n = 73,699), T1 + CD (n = 3379), T1D + depression (n = 1877), or T1D + CD + depression (n = 112). Results CD and depression were significantly associated (adjusted OR: 1.25 [1.03–1.53]). Females were more frequent in both the depression and the CD group compared with the T1D only group. Insulin pumps were used more frequently in T1D + CD and T1D + depression compared with T1D only (both p < .001). HbA1c was higher in T1D + depression (9.0% [8.9–9.0]), T1D + CD + depression (8.9% [8.6–9.2]), both compared with T1D only (8.2% [8.2–8.2], all p < .001). We found comorbid autism, attention deficit hyperactivity disorder, anxiety, schizophrenia, and eating disorders more frequently in the T1D + CD + depression group compared with T1D only (all p < .001). Conclusions CD and depression are associated in young T1D patients. The double load of T1D and CD may lead to an increased risk for depression. Depression was associated with additional psychological and neurological comorbidities. Aside from imperative CD screening after T1D diagnosis and regular intervals, depression screening might be helpful in routine care, especially in patients with diagnosed CD.

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