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Current Diabetes Reports
Published in: Current Diabetes Reports 10/2019

Open Access 01-10-2019 | Type 1 Diabetes | Pathogenesis of Type 1 Diabetes (A Pugliese and SJ Richardson, Section Editors)

What Have Slow Progressors Taught Us About T1D—Mind the Gap!

Authors: Kathleen M. Gillespie, Anna E. Long

Published in: Current Diabetes Reports | Issue 10/2019

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Abstract

Purpose of Review

Progression rate from islet autoimmunity to clinical diabetes is unpredictable. In this review, we focus on an intriguing group of slow progressors who have high-risk islet autoantibody profiles but some remain diabetes free for decades.

Recent Findings

Birth cohort studies show that islet autoimmunity presents early in life and approximately 70% of individuals with multiple islet autoantibodies develop clinical symptoms of diabetes within 10 years. Some “at risk” individuals however progress very slowly. Recent genetic studies confirm that approximately half of type 1 diabetes (T1D) is diagnosed in adulthood. This creates a conundrum; slow progressors cannot account for the number of cases diagnosed in the adult population.

Summary

There is a large “gap” in our understanding of the pathogenesis of adult onset T1D and a need for longitudinal studies to determine whether there are “at risk” adults in the general population; some of whom are rapid and some slow adult progressors.
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Metadata
Title
What Have Slow Progressors Taught Us About T1D—Mind the Gap!
Authors
Kathleen M. Gillespie
Anna E. Long
Publication date
01-10-2019
Publisher
Springer US
Keyword
Type 1 Diabetes
Published in
Current Diabetes Reports / Issue 10/2019
Print ISSN: 1534-4827
Electronic ISSN: 1539-0829
DOI
https://doi.org/10.1007/s11892-019-1219-1

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