Introduction
SNAIL Participants
Overall | BABY DIAB | DAISY | ABIS | BOX | Pittsburgh | |
---|---|---|---|---|---|---|
n | 132 | 22 | 30 | 11 | 36 | 33 |
Age at first antibody test, median (IQR) | 7 (1–18) | 1 | 1 (1–2) | 1 | 18 (13–38) | 18 (11–33)a |
Age at mAab+ sample, median (IQR) | 10 (5–20) | 5 (2–5) | 7 (4–10) | 5 | 18 (13–38) | 18 (11–37) |
Male, n (%) | 69 (54) | 16 (73) | 17 (57) | 7 (64) | 15 (42) | 17 (52) |
Years of follow-up since mAab+ detection, median (IQR) | 14 (12–19) | 13 (11–14) | 12 (11–13) | 13 (13–14) | 17 (14–24) | 20 (13–26) |
Diabetes free at follow-up, n (%) | 90 (68) | 12 (55) | 23 (77) | 10 (100) | 22 (61) | 23 (70) |
Genetic data available | 121 | 22 | 30 | 10 | 36 | 23 |
Genetic Factors Affecting Rate of Progression
Genetic Risk in SNAIL Participants: Slow Progressors Have Less HLA-Mediated Genetic Risk than Individuals Diagnosed in Childhood
Diagnosis age (years) | High risk (DQ2/DQ8) | Intermediate risk (either DQ2 or DQ8) | Low risk (not DQ2/not DQ8) | |
---|---|---|---|---|
BOX probands | Under 5 (%) | 42.2 | 49.1 | 8.6 |
5–9 (%) | 34.9 | 54.7 | 10.4 | |
10–14 (%) | 30.5 | 55.4 | 14.1 | |
15–20 (%) | 19.4 | 62.8 | 17.8 | |
SPs | N/A | 28.9 | 55.4 | 15.7 |
Mind the Gap!
- Do some individuals in the general population seroconvert to islet autoantibody positivity in late adolescence/adulthood or do they trigger autoimmunity in early age but this is more regulated and therefore progress more slowly, if at all?
- If the rate of onset of diabetes is the same in adulthood and childhood, are approximately one in three hundred of the adult UK population “at risk”?
- Do they develop multiple islet autoantibodies?
- Are there adults who progress rapidly from islet autoantibody positivity to clinical onset?
- Is the pathogenesis driven by GAD autoimmunity as described in cases of latent autoimmune diabetes of adults (LADA)?