Scale Based on 6-Month Glucose Change Predicts the Development of Type 1 Diabetes in People at High Risk
What to Know
Type 1 diabetes is an autoimmune disease that causes the immune system to attack the pancreas’s insulin-making cells. Relatives of people with type 1 diabetes are at higher risk of getting it themselves. At even greater risk are those who test positive for pancreatic autoantibodies, proteins that attack the pancreas. Studies that have involved such high-risk people have aimed to find ways to prevent type 1 diabetes. Because glucose levels in such people rise slowly before diabetes is diagnosed, researchers sought to determine whether glucose changes over a six-month period could predict who would develop diabetes.
The study included data from participants in two previous prevention studies. All were relatives of people with type 1 diabetes who had tested positive for pancreatic autoantibodies. All had an oral glucose tolerance test (OGTT) at the start and end of the 6-month study. An OGTT tells how well a person's body processes glucose. Using the results of the OGTTs, the researchers compared those who did not develop type 1 diabetes with those who did. They rated each participant’s likelihood of developing diabetes on a scale they had developed for this study.
The scale, called the Six-Month Glycemic Progression (PS6M), accurately predicted which participants would develop type 1 diabetes. PS6M scale scores were higher in participants who had two or more types of autoantibodies and for those who had lower levels of C-peptide (which tells how much insulin is being made by the pancreas). PS6M scale scores were also higher in those who had high risk scores in the prevention studies, based on OGTT results, age, and body mass index (BMI), an estimate of body fat based on height and weight.
Using the PS6M scale may hasten research into type 1 diabetes prevention, enabling researchers to develop meaningful results in a shorter time and with a smaller number of study participants. This would allow researchers to test preventive therapies more quickly. The PS6M scale can also help researchers learn how various risk factors influence glucose levels as high-risk patients progress toward type 1 diabetes. The scale, however, can only be used effectively in people similar to those involved in this study, and it should be further tested to prove it is truly useful.
The development and utility of a novel scale that quantifies the glycemic progression toward type 1 diabetes over 6 months, by Jay M. Sosenko and colleagues. Diabetes Care 2015;38:940–942 https://doi.org/10.2337/dc14-2787