The relationship between immune-mediated Type 1 diabetes mellitus and ethnicity.
OBJECTIVE
To determine the proportion of adults with newly diagnosed Type 1 diabetes that had immune-mediated disease (IMD).


METHODS
Two hundred fifteen patients with hyperglycemia and symptoms of insulin deficiency were screened for antibodies [islet cell antibodies (ICA), insulin autoantibodies (IAA), and glutamatic acid decarboxylase antibodies (GADA(65))] and HLA DR/DQ markers of IMD.


RESULTS
The mean age was 34 years and the mean BMI was 30.0 kg/m(2); 21.8% were non-Hispanic white (NHW), 27% were Latin American (LA), 47.9% were African American (AA), and 3.3% of other (OT) ethnic origins. Sixty individuals (28%) had one or more autoantibodies [Ab(+)]: 62% of NHW, 19% of AA, and 19% of LA. BMI was significantly lower (P<.01) in Ab(+). At least one HLA-DQ allele for susceptibility for IMD was identified in 52% of Ab(+).


CONCLUSIONS
These results suggest that islet cell autoantibodies and HLA markers of susceptibility for IMD are frequent in individuals of varying ethnic backgrounds, older age at onset, and higher body weight. Since early insulin therapy could delay what may otherwise be rapid progression to complete insulinopenia in patients with IMD, screening of adult diabetic patients for IMD at diagnosis may be of benefit to long-term management.
Avilés-Santa
Larissa
L
Department of Internal Medicine, University of Texas Southwestern Medical Center at Dallas, Parkland Health and Hospital System 5323 Harry Hines Boulevard G5.238, Dallas, TX 75390-8858, USA. maines.aviles-santa@utsouthwestern.edu
Maclaren
Noel
N
Raskin
Philip
P
D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D015992:Body Mass Index; D003920:Diabetes Mellitus / Q000453:epidemiology; D003922:Diabetes Mellitus, Type 1 / Q000276:immunology*; D005006:Ethnicity; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D044469:Racial Groups