title: The course of diabetes in children, adolescents and young adults: does the autoimmunity status matter?
abstract: BACKGROUND
  Initial classification of diabetes of young may require revision to improve diagnostic accuracy of different forms of diabetes. The aim of our study was to examine markers of beta-cell autoimmunity in a cohort of young (0-25 years) patients with type 1 diabetes and compare the presentation and course of the disease according to the presence of pancreatic antibodies.
  
  
  METHODS
  Cross-sectional population-based study was performed covering 100% of pediatric (n = 860) and 70% of 18-25 years old adult patients (n = 349) with type 1 diabetes in Lithuania.
  
  
  RESULTS
  No antibodies (GAD65, IA-2, IAA and ICA) were found in 87 (7.5%) cases. Familial history of diabetes was more frequent in those with antibodies-negative diabetes (24.1 vs. 9.4%, p < 0.001). Gestational age, birth weight and age at diagnosis was similar in both groups. Ketosis at presentation was more frequent in patients with autoimmune diabetes (88.1 vs. 73.5%, p < 0.05). HbA1c at the moment of investigation was 8.6 (3) vs. 8.7 (2.2)% in antibodies-negative and antibodies-positive diabetes groups, respectively, p > 0.05. In the whole cohort, neuropathy was found in 8.8% and nephropathy - in 8.1% of cases, not depending on autoimmunity status. Adjusted for age at onset, disease duration and HbA1c, retinopathy was more frequent in antibodies-negative subjects (13.8 vs. 7.8%, p < 0.05).
  
  
  CONCLUSIONS
  Antibodies-negative pediatric and young adult patients with type 1 diabetes in this study had higher incidence of family history of diabetes, higher frequency of retinopathy, less frequent ketosis at presentation, but similar age at onset, HbA1c, incidence of nephropathy and neuropathy compared to antibodies-positive patients.
authors.affiliation: Institute of Endocrinology, Medical Academy, Lithuanian University of Health Sciences, Eiveniu 2, LT-50161, Kaunas, Lithuania. rasa.verkauskiene@kaunoklinikos.lt.
authors.forename: Rasa
authors.initials: R
authors.lastname: Verkauskiene
authors.affiliation: Institute of Endocrinology, Medical Academy, Lithuanian University of Health Sciences, Eiveniu 2, LT-50161, Kaunas, Lithuania.
authors.forename: Evalda
authors.initials: E
authors.lastname: Danyte
authors.affiliation: Department of Endocrinology, Hospital of Lithuanian University of Health Sciences Kauno Klinikos, LT-50161, Kaunas, Lithuania.
authors.forename: Rimante
authors.initials: R
authors.lastname: Dobrovolskiene
authors.affiliation: Department of Endocrinology, Hospital of Lithuanian University of Health Sciences Kauno Klinikos, LT-50161, Kaunas, Lithuania.
authors.forename: Ingrida
authors.initials: I
authors.lastname: Stankute
authors.affiliation: Department of Endocrinology, Hospital of Lithuanian University of Health Sciences Kauno Klinikos, LT-50161, Kaunas, Lithuania.
authors.forename: Diana
authors.initials: D
authors.lastname: Simoniene
authors.affiliation: Department of Endocrinology, Hospital of Lithuanian University of Health Sciences Kauno Klinikos, LT-50161, Kaunas, Lithuania.
authors.forename: Dovile
authors.initials: D
authors.lastname: Razanskaite-Virbickiene
authors.affiliation: Institute of Endocrinology, Medical Academy, Lithuanian University of Health Sciences, Eiveniu 2, LT-50161, Kaunas, Lithuania.
authors.forename: Audrone
authors.initials: A
authors.lastname: Seibokaite
authors.affiliation: Institute of Endocrinology, Medical Academy, Lithuanian University of Health Sciences, Eiveniu 2, LT-50161, Kaunas, Lithuania.
authors.forename: Brone
authors.initials: B
authors.lastname: Urbonaite
authors.affiliation: Institute of Endocrinology, Medical Academy, Lithuanian University of Health Sciences, Eiveniu 2, LT-50161, Kaunas, Lithuania.
authors.forename: Nijole
authors.initials: N
authors.lastname: Jurgeviciene
authors.affiliation: Department of Endocrinology, Hospital of Lithuanian University of Health Sciences Kauno Klinikos, LT-50161, Kaunas, Lithuania.
authors.forename: Astra
authors.initials: A
authors.lastname: Vitkauskiene
authors.affiliation: Department of Child and Adolescent, University Hospital of Geneva, 1211, Geneva, Switzerland.|Diabetes Center, Faculty of Medicine, University of Geneva, 1211, Geneva, Switzerland.
authors.forename: Valerie
authors.initials: V
authors.lastname: Schwitzgebel
authors.affiliation: Institute of Endocrinology, Medical Academy, Lithuanian University of Health Sciences, Eiveniu 2, LT-50161, Kaunas, Lithuania.
authors.forename: Dalia
authors.initials: D
authors.lastname: Marciulionyte
mesh_terms: D000293:Adolescent; D000328:Adult; D015551:Autoimmunity; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D003922:Diabetes Mellitus, Type 1 / Q000175:diagnosis* / Q000276:immunology / Q000473:pathology; D016883:Diabetic Ketoacidosis / Q000453:epidemiology; D003930:Diabetic Retinopathy / Q000453:epidemiology; D018450:Disease Progression; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D050417:Insulin-Secreting Cells / Q000276:immunology*; D008097:Lithuania; D008297:Male; D055815:Young Adult
chemical_list: D006442:Glycated Hemoglobin; C517652:hemoglobin A1c protein, human
keywords: Adolescents; Children; Pancreatic antibodies; Type 1 diabetes; Young adults