Genetics of Type 1A Diabetes

LOVISELLI, ANDREA;
2009-01-01

Abstract

In their review article on the genetics of type 1A diabetes, Concannon et al. (April 16 issue),1 citing Aly et al.,2 state that the disorder develops in approximately 1 of 20 persons with high-risk HLA haplotypes. Such data refer to siblings of persons with type 1A diabetes. The real challenge is to identify the development of type 1A diabetes in the general population. A study involving 1031 healthy Sardinian schoolchildren (age range, 10 to 16 years)3 showed that after a followup period of 2.7 to 8.2 years, type 1A diabetes developed in 1 of 8 children who were positive for islet-related autoantibodies. Another study, involving 3000 schoolchildren,4 showed that type 1A diabetes developed within 10 years in children with two or more autoantibodies to distinct islet antigens, with a positive predictive value of 50%. We believe that only persons with islet autoantibodies would benefit from genotyping when “true risk variants for type 1 diabetes are fine mapped, identified, and characterized.”1
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