Objective
Our project aims to refine existing or develop new risk prediction tools specifically for adults, and use genetic, clinical, and lab data to better understand different pathways to diabetes in this group.
Background Rationale
Even though type 1 diabetes is often considered a disease of children, over half of new cases every year occur in adults. Adults with type 1 diabetes are often misdiagnosed and most of our understanding of how disease develops, and disease prediction was developed using information from high-risk children. Therefore, it is important to study better ways to predict the natural history of type 1 diabetes in adults at risk for developing diabetes so we can provide better care and counseling for these individuals.
Description of Project
While type 1 diabetes (T1D) is often thought of as a childhood disease, many people are actually diagnosed in adulthood. Some of these adults may benefit from treatments that could slow or stop the disease, but we still have a lot to learn about how T1D develops in adults and who is most at risk. Our early data show that, on average, adults who test positive for diabetes-related autoantibodies (markers of immune activity against the pancreas) are less likely to develop full-blown T1D than children. However, a smaller group of these adults still face a high risk. We’ve also found that tools used to predict T1D risk in children may help identify high-risk adults, but the cutoffs and details of those tools need to be adjusted for adults. In addition, some adults with these autoantibodies may actually have a form of diabetes more like type 2, highlighting the need for better ways to understand what kind of diabetes they have so we can give them the very best treatment. Our project aims to refine risk prediction tools specifically for adults, and use genetic, clinical, and lab data to better understand different pathways to diabetes in this group. In the long term, this work will help doctors tailor how they monitor and treat adults at risk for T1D, offering early treatment to those who need it and reassurance to those who don’t.
Anticipated Outcome
In the long term, this work will help doctors tailor how care providers monitor and treat adults at risk for type 1 diabetes, offering early treatment to those who need it and reassurance to those who don’t.
Relevance to T1D
This proposal is highly relevant to type 1 diabetes as it will develop new tools to counsel, monitor, and decide about treatment in adults with presymptomatic disease.