University of Oulu

Helminen, O., Pokka, T., Aspholm, S., Ilonen, J., Simell, O., Knip, M., & Veijola, R. (2022). Early glucose metabolism in children at risk for type 1 diabetes based on islet autoantibodies compared to low-risk control groups. Frontiers in Endocrinology, 13, 972714.

Early glucose metabolism in children at risk for type 1 diabetes based on islet autoantibodies compared to low-risk control groups

Saved in:
Author: Helminen, Olli1,2; Pokka, Tytti1; Aspholm, Susanna3;
Organizations: 1Department of Pediatrics, PEDEGO Research Group, Medical Research Center, Oulu University, Hospital and University of Oulu, Oulu, Finland
2Surgery Research Unit, Cancer and Translational Medicine Research Unit, Medical Research Center Oulu, University of Oulu and Oulu University Hospital, Oulu, Finland
3Tampere Centre for Child Health Research, Tampere University Hospital, Tampere, Finland
4Immunogenetics Laboratory, University of Turku, Turku, Finland
5Department of Pediatrics, University of Turku and Turku University Hospital, Turku, Finland
6Pediatric Research Center, New Children’s Hospital, Helsinki University Hospital, Helsinki, Finland
7Faculty of Medicine, University of Helsinki, Helsinki, Finland
Format: article
Version: published version
Access: open
Online Access: PDF Full Text (PDF, 2 MB)
Persistent link:
Language: English
Published: Frontiers Media, 2022
Publish Date: 2023-02-08


Background: Anatomic variation or early differences in glucose metabolism have been linked to the development of type 1 diabetes. We aimed to describe early glucose metabolism based on HbA1c, oral glucose tolerance test (OGTT), and random plasma glucose years before the presentation of type 1 diabetes in five risk groups based on autoantibody combinations. For the first time, we were able to include for comparison children with very low risk of progression to type 1 diabetes.

Methods: The Finnish Diabetes Prediction and Prevention birth cohort study screened newborn infants for HLA susceptibility to type 1 diabetes since 1994. Those carrying a risk genotype were prospectively followed up with islet autoantibody testing. Glucose parameters were obtained starting from the time of seroconversion. By 31 August 2014, 1162 children had developed at least one islet autoantibody and were included in the current study. Type 1 diabetes was diagnosed in 335 children (progressors). In the non-progressor groups, 207 developed multiple (≥2) biochemical islet autoantibodies, 229 a single biochemical autoantibody, 370 ICA only, and 64 transient autoantibodies. Children were divided into five risk groups. Glucose metabolism was evaluated.

Results: We observed lower HbA1c values in early follow-up 4.5 to 6.0 years before diagnosis in the progressors when compared to the same time in children with a single biochemical autoantibody or low-risk (ICA only and transient) participants, who did not progress to clinical type 1 diabetes. However, no such differences were observed in OGTTs or random plasma glucose. The variation was minimal in glucose values in the low-risk groups.

Conclusion: We report the possibility of early alteration in glucose metabolism in future progressors. This could suggest early defects in multiple glucose-regulating hormones.

see all

Series: Frontiers in endocrinology
ISSN: 1664-2392
ISSN-E: 1664-2392
ISSN-L: 1664-2392
Volume: 13
Article number: 972714
DOI: 10.3389/fendo.2022.972714
Type of Publication: A1 Journal article – refereed
Field of Science: 3123 Gynaecology and paediatrics
3121 General medicine, internal medicine and other clinical medicine
Funding: This work was supported by the following grants. International: JDRF International (grants 4-1998-274, 4-1999-731, 4-2001-435); European Union (grant BMH4-CT98-3314); Novo Nordisk Foundation. Finland: Academy of Finland (Centre of Excellence in Molecular Systems Immunology and Physiology Research 2012-2017, Decision No. 250114); TEKES National Technology Agency of Finland; Special Research Funds for University Hospitals in Finland; Finnish Office for Health Technology Assessment; Diabetes Research Foundation, Finland; Sigrid Juselius Foundation; Emil Aaltonen Foundation; Jalmari and Rauha Ahokas Foundation; Signe and Ane Gyllenberg Foundation; the Research Foundation of Orion Corporation; Foundation for Pediatric Research; Alma and KA Snellman Foundation; Päivikki and Sakari Sohlberg Foundation, the Finnish Medical Foundation and Finnish Cultural Foundation, North Ostrobothnia Regional Fund. The funders were not involved in the study design, collection, analysis, interpretation of data, the writing of this article, or the decision to submit it for publication. All authors declare no other competing interests.
Copyright information: © 2022 Helminen, Pokka, Aspholm, Ilonen, Simell, Knip and Veijola. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.