A new blueprint to aid physicians in predicting risk for type ...( s of an attack on the insulin-producing...),Health

Newer tests use biochemical markers to detect islet autoantibodies, and these autoantibody responses signify a cause and effect relationship between type 1 diabetes and autoimmune phenomena targeting pancreatic insulin-producing cells. "In the mid 1990s, we found that a combination of autoantibodies could predict type 1 diabetes over time in individuals at risk of developing type 1 diabetes," Dr. Pietropaolo said. "However, there were some patients who were positive for a combination of these biochemical markers but still did not develop type 1 diabetes."

Anytime a marker is used to predict disease, there is some margin of error. But Dr. Pietropaolo and his coauthors wondered if they could do better and if the older assay held the key. In the new study, they looked at both levels of islet cell antibodies and biochemical markers of autoantibodies in 1,484 first-degree relatives of people with type 1 diabetes.

Those who tested positive for the two most commonly recognized autoantibodies had a 14 percent risk of developing type 1 diabetes after 10 years. However, those who displayed those two autoantibodies along with islet cell antibodies had an 80 percent risk after just 6.7 years. "The surprise was that by using these older assays in combination with the newer tests, we were able to more accurately predict type 1 diabetes in the family members of those with type 1 diabetes," Dr. Pietropaolo said.

In addition, family members with a certain subtype of islet cell antibody developed type 1 diabetes after fewer years than others. The study authors suspect that this antibody subtype is recognizing and attacking a previously unknown protein associated with insulin requiring diabetes.
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Contact: Marc Lukasiak
marc.lukasiak@chp.edu
412-692-7919
American Medical Association
27-Oct-2005