Members of the TEDDY Study Group are listed in Appendix
Children followed in the TEDDY study are diagnosed with type 1 diabetes at an early stage of disease
Article first published online: 27 AUG 2013
© 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd
Volume 15, Issue 2, pages 118–126, March 2014
How to Cite
Children followed in the TEDDY study are diagnosed with type 1 diabetes at an early stage of disease., , , , , , , , , , , , .
- Issue published online: 20 MAR 2014
- Article first published online: 27 AUG 2013
- Manuscript Accepted: 28 JUN 2013
- Manuscript Revised: 24 JUN 2013
- Manuscript Received: 27 MAR 2013
- National Institute of Diabetes and Digestive and Kidney Diseases
- National Institute of Allergy and Infectious Diseases
- National Institute of Child Health and Human Development
- National Institute of Environmental Health Sciences
- Juvenile Diabetes Research Foundation
- Centers for Disease Control and Prevention (CDC)
- follow-up studies;
- TEDDY study;
- type 1 diabetes
The Environmental Determinants of Diabetes in the Young (TEDDY) study is designed to identify environmental exposures triggering islet autoimmunity and type 1 diabetes (T1D) in genetically high-risk children. We describe the first 100 participants diagnosed with T1D, hypothesizing that (i) they are diagnosed at an early stage of disease, (ii) a high proportion are diagnosed by an oral glucose tolerance test (OGTT), and (iii) risk for early T1D is related to country, population, human leukocyte antigen (HLA)-genotypes and immunological markers.
Autoantibodies to glutamic acid decarboxylase (GADA), insulinoma-associated protein 2 (IA-2) and insulin (IAA) were analyzed from 3 months of age in children with genetic risk. Symptoms and laboratory values at diagnosis were obtained and reviewed for ADA criteria.
The first 100 children to develop T1D, 33 first-degree relatives (FDRs), with a median age 2.3 yr (0.69–6.27), were diagnosed between September 2005 and November 2011. Although young, 36% had no symptoms and ketoacidosis was rare (8%). An OGTT diagnosed 9/30 (30%) children above 3 yr of age but only 4/70 (5.7%) below the age of 3 yr. FDRs had higher cumulative incidence than children from the general population (p < 0.0001). Appearance of all three autoantibodies at seroconversion was associated with the most rapid development of T1D (HR = 4.52, p = 0.014), followed by the combination of GADA and IAA (HR = 2.82, p < 0.0001).
Close follow-up of children with genetic risk enables early detection of T1D. Risk factors for rapid development of diabetes in this young population were FDR status and initial positivity for GADA, IA-2, and IAA or a combination of GADA and IAA.