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Risk Score Useful for Early ID of Preclinical Type 1 Diabetes

DPTRS threshold score of 9.00 identifies those likely to progress to type 1 diabetes within two years

THURSDAY, May 10 (HealthDay News) -- Using a threshold of 9.00 on the Diabetes Prevention Trial-Type 1 Risk Score (DPTRS), it is possible to identify individuals who are likely to progress to type 1 diabetes (T1D) within two years or who are in a preclinical state of the disease, according to a study published online April 30 in Diabetes Care.

Jay M. Sosenko, M.D., of the University of Miami, and colleagues assessed the utility of the DPTRS, which was developed in the Diabetes Prevention Trial-Type 1 (DPT-1) and validated in the TrialNet Natural History Study (TNNHS), for identifying individuals who are likely to progress to T1D within two years. This score includes C-peptide and glucose indices from oral glucose tolerance testing, age, and body mass index. When the DPTRS threshold was first exceeded and at the first occurrence of glucose abnormalities, the cumulative incidences of T1D were determined.

After a DPTRS threshold of 9.00, the researchers found that the two-year risks estimates were 0.88 in DPT-1 and 0.77 in TNNHS, based on cumulative incidence curves. The 9.00 threshold was exceeded an average of 0.81 years prior to the conventional diagnosis, among those who developed T1D in DPT-1. Compared with levels at diagnosis, post-challenge C-peptide levels were considerably higher when the 9.00 threshold was first exceeded.

"This study shows that it is now possible to identify individuals who are in a state of preclinical T1D, when C-peptide levels are appreciably higher," the authors write. "It appears that a 9.00 DPTRS threshold can be used for this purpose in autoantibody-positive populations."

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