Conference Coverage

Risk score can predict type 1 diabetes



CHIGAGO – In their ongoing quest to refine and identify methods for earlier intervention and prevention of type 1 diabetes, researchers at the University of Miami have developed a risk score, which includes the individual's age, and so far has shown to be highly predictive of symptomatic type 1 diabetes diagnosis. The risk score, or a modification of it, "could potentially provide an additional means for diagnosing type 1 diabetes," said Dr. Jay M. Sosenko, professor of medicine and epidemiology at the University of Miami.

The risk score is based on variables that are most predictive of who would develop symptomatic type 1 diabetes, including body mass index, age, fasting C-peptide levels, a measure of overall C-peptide production, and a measure of overall glucose. So far, the study has shown individuals whose risk scores passed a certain threshold were highly likely to develop symptomatic type 1 diabetes within roughly 2 years.

Dr. Sosenko analyzed the Diabetes Prevention Trial of Type 1 Diabetes (DPT1) database to identify the risk scores. He then applied the DPT1 Risk Score, or DPTRS, to data from the large, multi-center study TrialNet Natural History Study, which is also known as the Pathway to Prevention Study. He spoke about his findings during the annual American Diabetes Association Meeting.

"The DPTRS can identify even those who have normal glucose tolerance but who are nonetheless at risk, in part because it takes age into account," he said in a news release. "Dysglycemia, which is currently used to identify high risk individuals, is based upon the glucose thresholds of adults and these thresholds might not be appropriate for children," said Dr. Sosenko.

In this video, Dr. Sosenko speaks about the clinical applicability of DPTRS. The ongoing developments in the field could ultimately lead to universal childhood screening and further on, immunization of children "to prevent the ongoing process associated with type 1 diabetes from taking hold," said Dr. Richard A. Insel, chief scientific officer for the Juvenile Diabetes Research Foundation.

But in the meantime, "everybody should be aware of the symptoms of diabetes to prevent the onset of ketoacidosis," said Dr. Insel. "The rate of diabetic ketoacidosis hasn't changed over the last 20 years, and many of these individuals are being seen in the health care system and not being diagnosed. So everybody from teachers to parents to health care providers should be aware of symptoms of diabetes so we can prevent ketoacidosis, especially in children."

Dr. Sosenko had no disclosures. TrialNet is sponsored by the National Institute of Diabetes and Digestive and Kidney Disease, and receives support from the ADA and the JDRF.

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