Type 1 Diabetes is Predicted by Autoantibodies

In type 1 diabetes, characteristic autoantibodies against islet cell antigens often appear quite early in the blood of young patients. ­Through the detection of multiple autoantibodies, the disease can often be diagnosed in the preclinical stage.

The autoimmune disease type 1 diabetes often manifests during childhood and adolescence. Characteristic markers of the disease are autoantibodies – i.e. immunoglobulins directed against the body’s own components. They appear when insulin producing cells in the pancreas are destroyed and may be present in the young patient's blood already at the age of six months to three years. In a 20-year period after the first appearance of so-called multiple autoantibodies – sooner or later depending on the presence of certain risk factors – the disease manifests.

In order to determine the progression rate more precisely, scientists from the Institute of Diabetes Research compared the data from their own studies (BABYDIET and BABYDIAB) with the data of two other prospective cohort studies (DAISY from Colorado and DIPP from Finland). Overall, they were able to analyze the results of 13 377 children over a period of 20 years, making this study the largest of its kind in the world.

Anette-Gabriele Ziegler and Christiane Winkler of the Institute of Diabetes Research and their colleagues from international cooperative projects found that 70 percent of children who have more than one type of autoantibodies against islet cells in the pancreas develop type 1 diabetes within ten years. Over a period of 15 or 20 years, the percentage of children is even 85 percent or almost 100 percent. Subjects with only one type of autoantibodies, however, develop type 1 diabetes only in 15 percent of the cases within ten years, and children without autoantibodies almost never develop type 1 diabetes.

These results show that the development of type 1 diabetes is usually predictable. Therefore, the detection of autoantibodies provides a relatively simple and cost-efficient way to diagnose type 1 diabetes at an early stage and, if applicable, in time to begin preventive and therapeutic measures.

Islet cell autoantibodies directed against different components of the insulin-producing beta cells of the pancreas are characteristic markers for type 1 diabetes. Due to the autoimmune process, the body is no longer sufficiently supplied with insulin; if the destruction of the beta cells exceeds a certain threshold, the disease manifests and blood glucose levels rise.