title: Phenotype changes at the onset of type 1 diabetes in young adults from a mediterranean area throughout the last decade.
abstract: The Accelerator hypothesis postulates that Type 1 Diabetes (T1D) and Type 2 Diabetes are mostly the same disorder. Till now, the data testing the hypothesis and the importance of BMI and insulin resistance in the development of T1D comes almost exclusively from childhood. Our study aimed to investigate changes in clinical and metabolic characteristics of young adults at diagnosis of T1D during the last decade in a Mediterranean area. Ninety-three adults (> or =18 years) with newly diagnosed T1D were evaluated from our database. Thirty-one of them were diagnosed in the period 07/1994-1995 (G95), 39 between 07/1998 and 1999 (G99) and 23 in 2003 (G03). Plasma C-peptide measurements were performed before and 6 min after intravenous injection of 1 mg of glucagon. In those subjects with a basal C-peptide > 0.2 nmol/l, insulin resistance was evaluated using the HOMA-2 model. HbAc, GAD, IA2 and insulin autoantibodies were measured. There was not a significant rise in BMI at diagnosis of T1D in young adults admitted to our Hospital. This was also the case when BMI after 4 weeks of diagnosis was considered (23.7 +/- 3.6, 23,6 +/- 2.4 and 23.4 +/- 3.3 kg/m2, G95 G99 and G03, respectively). In the entire group of subjects, we could not observed any relationship between the patients BMI and age at diagnosis. Likewise, we could not observed differences in any of the clinical, immunological or metabolic characteristics. IR was not different between groups (G95 n=18, 0.73 +/- 0.21; G99 n=29, 0.86 +/- 0.33; G3 n=13, 0.66 +/- 0.34) and was not related to the age at diagnosis. In summary, our data collected from young adults with newly diagnosed T1D from a Mediterranean area indicates that the phenotype, including BMI, at the onset of the disease has not substantially varied during the last decade. In spite of our data do not fit with the accelerator hypothesis the postulate could be of interest in a different age group.
authors.affiliation: Endocrinology and Diabetes Unit, Institut d'Investigacions Biomtdicas August Pi i Sunyer, Hospital Clinic i Universitari, Villarroel 170, 08036 Barcelona, Spain.
authors.forename: M
authors.initials: M
authors.lastname: Giménez
authors.forename: J
authors.initials: J
authors.lastname: Nicolau
authors.forename: J
authors.initials: J
authors.lastname: Vidal
authors.forename: R
authors.initials: R
authors.lastname: Casamitjana
authors.forename: I
authors.initials: I
authors.lastname: Conget
mesh_terms: D000328:Adult; D017668:Age of Onset; D015992:Body Mass Index; D003922:Diabetes Mellitus, Type 1 / Q000453:epidemiology*; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D015994:Incidence; D007657:Ketone Bodies / Q000652:urine; D008297:Male; D019083:Mediterranean Region / Q000453:epidemiology; D010641:Phenotype
chemical_list: D006442:Glycated Hemoglobin; D007657:Ketone Bodies