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Oulun yliopiston väitöskirjat




GLUCOSE METABOLISM IN PRECLINICAL TYPE 1 DIABETES, ACTA UNIVERSITATIS OULUENSIS D Medica 13 82


ISBN-13:978-952-62-1324-8 
Kieli:englanti 
Kustantaja:Oulun yliopisto 
Oppiaine:Lääketiede 
Painos:Osajulkaisuväitöskirjan yhteenveto-osa 
Painosvuosi:2016 
Sijainti:Print Tietotalo 
Sivumäärä:106 
Tekijät:HELMINEN OLLI 

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Type 1 diabetes is considered to be a T cell-mediated autoimmune disease characterized by destruction of the pancreatic beta cells. Its prediction is currently based on diabetes-associated autoantibodies, giving a cumulative risk of 84% during 15 years of follow-up since seroconversion. Prediction of the timing of clinical onset has remained challenging, however. This thesis examines glucose metabolism in autoantibody-positive children with a high risk of developing type 1 diabetes. Out of a total of 14,876 children with an increased genetic risk followed up from birth in the Finnish DIPP study, 567 developed ≥2 autoantibodies during the follow-up and 255 of these (45%) were diagnosed with type 1 diabetes until the end of December 2011. The glucose parameters measured were HbA1c, OGTT and random plasma glucose with 3 to 12 months interval. Seven-day continuous glucose monitoring (CGM) was performed on an age and sex-matched cohort. We showed that rising HbA1c, impaired glucose tolerance in OGTT, random plasma glucose values of ≥7.8mmol/l and potentially CGM can predict type 1 diabetes with a median time to diagnosis of approximately one year. Our results suggest that especially HbA1c and random plasma glucose are cost-effective and improve the prediction of diabetes. These markers may be useful for monitoring the response to treatment in prevention studies.


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