Diabetes autoantibodies do not predict progression to diabetes in adults: the Diabetes Prevention Program. Issue 9 (9th April 2014)

• Record Type: Journal Article
• Authors: Dabelea, D.; Ma, Y.; Knowler, W. C.; Marcovina, S.; Saudek, C. D.; Arakaki, R.; White, N. H.; Kahn, S. E.; Orchard, T. J.; Goldberg, R.; Palmer, J.; Hamman, R. F.; The Diabetes Prevention Program Research Group
• Is Part Of: Diabetic medicine. Volume 31:Issue 9(2014:Sep.)
• Page Start: 1064
• Page End: 1068
• Publication Date: 2014-04-09
• Subjects: Diabetes -- Periodicals; 616.462
• DOI: 10.1111/dme.12437
• Languages: English
• ISSNs: 0742-3071

Abstract

<abstract abstract-type="main" id="dme12437-abs-0001"> <title>Abstract</title> <sec id="dme12437-sec-0001" sec-type="section"> <title>Aims</title> <p>To determine if the presence of diabetes autoantibodies predicts the development of diabetes among participants in the Diabetes Prevention Program.</p> </sec> <sec id="dme12437-sec-0002" sec-type="section"> <title>Methods</title> <p>A total of 3050 participants were randomized into three treatment groups: intensive lifestyle intervention, metformin and placebo. Glutamic acid decarboxylase (GAD) 65 autoantibodies and insulinoma‐associated‐2 autoantibodies were measured at baseline and participants were followed for 3.2 years for the development of diabetes.</p> </sec> <sec id="dme12437-sec-0003" sec-type="section"> <title>Results</title> <p>The overall prevalence of GAD autoantibodies was 4.0%, and it varied across racial/ethnic groups from 2.4% among Asian‐Pacific Islanders to 7.0% among non‐Hispanic black people. There were no significant differences in BMI or metabolic variables (glucose, insulin, HbA<sub>1c</sub>, estimated insulin resistance, corrected insulin response) stratified by baseline GAD antibody status. GAD autoantibody positivity did not predict diabetes overall (adjusted hazard ratio 0.98; 95% CI 0.56–1.73) or in any of the three treatment groups. Insulinoma‐associated‐2 autoantibodies were positive in only one participant (0.033%).</p> </sec> <sec id="dme12437-sec-0004" sec-type="section"> <title>Conclusions</title> <p>These data suggest that 'diabetes autoimmunity', as reflected by GAD antibodies and insulinoma‐associated‐2 autoantibodies, in middle‐aged individuals at risk for diabetes is not a clinically relevant risk factor for progression to diabetes.</p> </sec> </abstract>