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. 2011 Jul;34(7):1628-33.
doi: 10.2337/dc10-2324. Epub 2011 Jun 2.

Etiological approach to characterization of diabetes type: the SEARCH for Diabetes in Youth Study

Dana Dabelea  1 , Catherine Pihoker, Jennifer W Talton, Ralph B D'Agostino Jr, Wilfred Fujimoto, Georgeanna J Klingensmith, Jean M Lawrence, Barbara Linder, Santica M Marcovina, Elizabeth J Mayer-Davis, Giuseppina Imperatore, Lawrence M Dolan; SEARCH for Diabetes in Youth Study
Affiliations

Etiological approach to characterization of diabetes type: the SEARCH for Diabetes in Youth Study

Dana Dabelea et al. Diabetes Care. 2011 Jul.

Abstract

Objective: To describe an etiologic approach to classification of diabetes types in youth based on the 1997 American Diabetes Association (ADA) framework, using data from the SEARCH for Diabetes in Youth Study.

Research design and methods: SEARCH conducted a comprehensive assessment of 2,291 subjects aged <20 years with recently diagnosed diabetes. Using autoimmunity (at least one of two diabetes autoantibodies) and insulin sensitivity (equation validated against hyperinsulinemic-euglycemic clamps) as the main etiologic markers, we described four categories along a bidimensional spectrum: autoimmune plus insulin-sensitive (IS), autoimmune plus insulin-resistant (IR), nonautoimmune plus IS, and nonautoimmune plus IR. We then explored how characteristics, including genetic susceptibility to autoimmunity (HLA genotypes), insulin deficiency, and clinical factors varied across these four categories.

Results: Most subjects fell into either the autoimmune plus IS (54.5%) or nonautoimmune plus IR categories (15.9%) and had characteristics that align with traditional descriptions of type 1 or type 2 diabetes. The group classified as autoimmune plus IR (19.5%) had similar prevalence and titers of diabetes autoantibodies and similar distribution of HLA risk genotypes to those in the autoimmune plus IS group, suggesting that it includes individuals with type 1 diabetes who are obese. The group classified as nonautoimmune plus IS (10.1%) likely includes individuals with undetected autoimmunity but may also include those with monogenic diabetes and thus requires further testing.

Conclusions: The SEARCH study offers researchers and clinicians a practical application for the etiologic classification of diabetes type and at the same time identifies a group of youths who would benefit from further testing.

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Figures

Figure 1
Figure 1
Proportional distribution of etiologic categories among SEARCH participants by race/ethnicity
See this image and copyright information in PMC

References

    1. National Diabetes Data Group Classification and diagnosis of diabetes mellitus and other categories of glucose intolerance. Diabetes 1979;28:1039–1057 - PubMed
    1. American Diabetes Association Report of the Expert Committee on the Diagnosis and Classification of Diabetes Mellitus. Diabetes Care 1997;20:1183–1197 - PubMed
    1. Gale EA: Declassifying diabetes. Diabetologia 2006;49:1989–1995 - PubMed
    1. Dabelea D, Bell RA, D’Agostino RB, Jr, et al. ; Writing Group for the SEARCH for Diabetes in Youth Study Group Incidence of diabetes in youth in the United States. JAMA 2007;297:2716–2724 - PubMed
    1. Ingram DD, Parker JD, Schenker N, et al. United States Census 2000 population with bridged race categories: data evaluation and methods research. Vital Health Stat II 2003;135:1–55 - PubMed