Disease Predictor for Relatives of Diabetes Patients Identified

Impaired β-cell glucose sensitivity predictor of progression in type 1 diabetes patients' relatives

THURSDAY, April 15 (HealthDay News) -- In relatives of type 1 diabetes patients, who are at high risk for developing the disease, impaired β-cell glucose sensitivity is a strong predictor of disease progression, according to a study published in the March issue of Diabetes.

Ele Ferrannini, M.D., of the University of Pisa School of Medicine in Italy, and colleagues conducted a study of 328 islet cell autoantibody-positive, diabetes-free relatives of type 1 diabetes patients, with a median age of 11 years. The participants took a total of 2,143 oral glucose tolerance tests at baseline and every six months.

After 2.7 years of follow-up, 115 subjects had been diagnosed with diabetes. Although baseline insulin sensitivity, fasting insulin secretion and total postglucose insulin output were similar among those who progressed to diabetes and those who did not, the researchers found that, among the progressors, β-cell glucose sensitivity was impaired and it predicted incident diabetes independently of age, sex, clinical risk and body mass index. In the progressors, 2-h glucose levels did not change much until 0.78 years before diagnosis, and then they started to rise rapidly. Glucose sensitivity began to decline earlier than the plasma glucose surge.

"The time trajectories of plasma glucose are frequently biphasic, with a slow linear increase followed by a rapid surge, and are anticipated by a further deterioration of β-cell glucose sensitivity," the authors write. "A defect in β-cell glucose sensitivity is detectable in at-risk subjects years before diagnosis, anticipates plasma glucose increments, and in combination with progressive insulin resistance and secretory insufficiency produces the acute hyperglycemia of type 1 diabetes."

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