title: Brief communication: early appearance of islet autoantibodies predicts childhood type 1 diabetes in offspring of diabetic parents.
abstract: BACKGROUND
  The development of type 1 diabetes mellitus is preceded by autoimmunity against islet beta cells.
  
  
  OBJECTIVE
  To determine the risk for islet autoimmunity and childhood diabetes in offspring of affected parents.
  
  
  METHODS
  Prospective cohort study.
  
  
  METHODS
  German BABYDIAB study.
  
  
  METHODS
  1610 offspring of parents with type 1 diabetes.
  
  
  METHODS
  Autoantibodies to islet autoantigens were measured at 9 months, 2 years, 5 years, and 8 years of age.
  
  
  RESULTS
  By 5 years of age, the frequency of islet autoantibodies was 5.9% (95% CI, 4.6% to 7.2%), the frequency of multiple islet autoantibodies was 3.5% (CI, 2.5% to 4.5%), and the frequency of diabetes was 1.5% (CI, 0.9% to 2.1%). The risk for diabetes was highest in offspring with multiple autoantibodies (40% within 5 years vs. 3% in offspring with single autoantibodies; P = 0.005). Progression to multiple islet autoantibodies was fastest in children who were autoantibody positive by age 2 years (P < 0.001), and progression to diabetes was inversely related to the age of positivity for multiple autoantibodies (P = 0.02).
  
  
  CONCLUSIONS
  The findings are limited to childhood diabetes in affected families.
  
  
  CONCLUSIONS
  Childhood autoimmune diabetes is associated with autoimmunity that starts before 2 years of age.
authors.affiliation: Diabetes Research Institute and Academic Hospital Schwabing, Munich, Germany.
authors.forename: Michael
authors.initials: M
authors.lastname: Hummel
authors.forename: Ezio
authors.initials: E
authors.lastname: Bonifacio
authors.forename: Sandra
authors.initials: S
authors.lastname: Schmid
authors.forename: Markus
authors.initials: M
authors.lastname: Walter
authors.forename: Annette
authors.initials: A
authors.lastname: Knopff
authors.forename: Anette-G
authors.initials: AG
authors.lastname: Ziegler
mesh_terms: D001323:Autoantibodies / Q000097:blood*; D002648:Child; D002675:Child, Preschool; D003922:Diabetes Mellitus, Type 1 / Q000235:genetics* / Q000276:immunology*; D005260:Female; D020022:Genetic Predisposition to Disease; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007515:Islets of Langerhans / Q000276:immunology*; D008297:Male; D011446:Prospective Studies; D012307:Risk Factors
chemical_list: D001323:Autoantibodies