Pediatric Diabetes最新文献

{"title":"The Psychometric Properties of the Type 1 Diabetes Mellitus Screening Acceptability Assessment (DMSA) Scale among General Population.","authors":"Iman S Al-Gadi, Amirah D Albalawi, Reem A Al Khalifah","doi":"10.1155/2024/1286029","DOIUrl":"https://doi.org/10.1155/2024/1286029","url":null,"abstract":"<p><strong>Background: </strong>Type 1 diabetes mellitus (T1DM) screening facilitates access to early intervention and prevention of severe complications, such as diabetic ketoacidosis. Despite its significance, many countries lack a systematic T1DM screening program. Understanding how the public perceives T1DM screening for children is essential for successfully implementing such programs but is currently an area with limited research. Our study aims to fill this gap by developing a standardized tool designed to assess the acceptability of T1DM screening programs for children, focusing on caregiver perspectives within the general population.</p><p><strong>Materials and methods: </strong>We developed the Type 1 Diabetes Mellitus Screening Acceptability (DMSA) scale based on the theoretical framework of acceptability and integrated components from the Pediatric Testing Attitudes Scale-Diabetes (P-TAS-D). It covers a broad spectrum of acceptability constructs. The DMSA scale underwent iterative modifications following expert feedback to refine clarity and content validity. We tested the scale in both Arabic and English with adults living in Saudi Arabia, regardless of their parental status, focusing on the potential of screening their children. The psychometric strengths of the scale were evaluated through reliability analyses and exploratory factor analysis.</p><p><strong>Results: </strong>Of the 599 participants, the majority were female (89.2%), with a mean age of 35.9 ± 8.6 years. The final DMSA scale consists of 10 items, with two distinct factors: \"individual acceptability\" and \"psychosocial acceptability.\" The mean total score was 42.9 ± 5.1 across a potential range of 10-50 points. The English and Arabic versions of the scale demonstrated strong reliability, with Cronbach's alpha values of 0.84 and 0.79, respectively.</p><p><strong>Conclusions: </strong>The DMSA scale emerges as a valid and reliable tool for gauging the acceptability of the general population of screening children for T1DM. It integrates key elements of the acceptability construct, pivotal for guiding the implementation of culturally sensitive T1DM screening initiatives. Future research should expand its application across various cultural settings and examine the correlation between scale scores and actual screening behaviors.</p>","PeriodicalId":19797,"journal":{"name":"Pediatric Diabetes","volume":"2024 ","pages":"1286029"},"PeriodicalIF":3.9,"publicationDate":"2024-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12017164/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144031169","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Supporting Adolescents and Young Adults through Digitally Mediated Type 1 Diabetes Transition Care: A Qualitative Descriptive Study.","authors":"Noor El-Dassouki, Madison Taylor, Kaylen J Pfisterer, Ashish Saragadam, Meranda Nakhla, Marley Greenberg, Alanna Landry, Geetha Mukerji, Elise Mok, Anne-Sophie Brazeau, Jessica C Kichler, Joseph A Cafazzo, Rayzel Shulman","doi":"10.1155/2024/3721768","DOIUrl":"https://doi.org/10.1155/2024/3721768","url":null,"abstract":"<p><strong>Objective: </strong>The time during which adolescents and young adults (AYAs) living with Type 1 Diabetes (T1D) transition from pediatric to adult care is associated with blood sugar levels outside of target ranges, care gaps, and an increased risk of acute diabetes complications. The aim of this study was to understand (1) the perspectives of AYAs and providers about the strengths, challenges, and opportunities of transition care and (2) the role of digital technologies in supporting the transition to adult care. <i>Research Design and Methods</i>. We conducted a qualitative descriptive study that involved 43 semistructured interviews in French or English with AYA living with T1D (aged 16-25; <i>n</i> = 22) and pediatric or adult diabetes health care providers (HCPs) (<i>n</i> = 21).</p><p><strong>Results: </strong>We identified three themes. First, transition care is not standardized and varies widely, and there is a lack of awareness of transition guidelines. Second, virtual care can simultaneously hinder and help relationship-building between providers and AYA. Third, AYAs value a holistic approach to care; both HCPs and AYA highlighted the opportunity to better support overall mental wellbeing.</p><p><strong>Conclusions: </strong>The design of digital technologies to support T1D transition care should consider methods for standardizing holistic care delivery and integrating hybrid diabetes care visits to support access to transition care. These findings can inform future transition intervention development that leverages existing transition guidelines, targets holistic care model integration, and considers quantitative diabetes metrics in conjunction with broader life experiences of AYA when providing transition care.</p>","PeriodicalId":19797,"journal":{"name":"Pediatric Diabetes","volume":"2024 ","pages":"3721768"},"PeriodicalIF":3.9,"publicationDate":"2024-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12017227/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144041161","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Psychosocial-Spiritual Experiences and Outcomes in Parents of Children with Type 1 Diabetes Mellitus from the Middle East and North Africa Region: A Systematic Review.","authors":"Mariam Asaad, Haya Abu Ghazaleh, Vasiliki Tzouvara, Xiaoyan Zhao, Jackie Sturt","doi":"10.1155/2024/6111661","DOIUrl":"https://doi.org/10.1155/2024/6111661","url":null,"abstract":"<p><strong>Background: </strong>Type 1 diabetes mellitus (T1DM) is prevalent in the Middle East and North Africa (MENA). Parents of children or young people (CYP) with T1D experience shock, devastation, guilt, and societal blame, which impact both physical and psychosocial-spiritual aspects of their lives. However, our knowledge of the breadth of these psychosocial-spiritual experiences and how they are assessed is limited.</p><p><strong>Aim: </strong>(1) To examine the diabetes-specific psychosocial experiences of parents of CYP with T1D in the MENA region; (2) to assess the person-reported outcome measures (PROMs) that measure the psychosocial-spiritual outcomes in this population; and (3) to assess their reliability and validity.</p><p><strong>Materials and methods: </strong>A systematic review methodology was implemented using the preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines. Ovid MEDLINE, Embase, APA PsycINFO, CINAHL, and Global Health databases were searched for relevant articles. A narrative synthesis approach was used for data analysis.</p><p><strong>Results: </strong>Twenty-three studies were included. We identified four categories: (1) spiritual functioning, parents' ability to accept and cope with their CYP's condition, (2) psychological functioning, parents' emotional distress due to insufficient diabetes-related knowledge and skills, (3) social functioning, describing financial challenges, social support experiences, and cultural concerns faced by parents, and (4) physical functioning, parents' struggle with sleep deprivation. Our results revealed methodological and conceptual limitations of the current tools measuring these experiences. Some of the limitations of this review are (1) heterogeneity in the tools captured perhaps some but not all domains of the parents' psychosocial experiences, (2) only English studies were included, as no Arabic studies were found.</p><p><strong>Conclusion: </strong>Our studied population experiences psychosocial-spiritual distress by managing the condition of their CYP and needs culturally specific psychosocial-spiritual support. Further studies are needed to develop a new measure to specifically assess the psychosocial-spiritual outcomes of this population.</p>","PeriodicalId":19797,"journal":{"name":"Pediatric Diabetes","volume":"2024 ","pages":"6111661"},"PeriodicalIF":3.9,"publicationDate":"2024-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12016858/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144015970","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trends in CVD Risk Factors for Youth with Incident Diabetes: SEARCH for Diabetes in Youth.","authors":"Ronny A Bell, Joseph Rigdon, Anna Bellatorre, Dana Dabelea, Ralph D'Agostino, Jasmin Divers, Lawrence M Dolan, Elizabeth Jensen, Angela D Liese, Eva Lustigova, Santica M Marcovina, Lina Merjaneh, David J Pettitt, Catherine Pihoker, Amy S Shah, Andrew M South, Lynne E Wagenknecht","doi":"10.1155/2024/5213520","DOIUrl":"https://doi.org/10.1155/2024/5213520","url":null,"abstract":"<p><strong>Objectives: </strong>Cardiovascular disease (CVD) is the leading cause of death and disability among persons with diabetes. Early intervention on cardiovascular risk factors (CRFs) is important in reducing CVD burden. The SEARCH for Diabetes in Youth study assessed CRFs in incident cohorts of youth aged <20 years established from 2002 to 2016. <i>Research Design and Methods</i>. Regression models assessed trends over each incident year for lipids (total cholesterol (TC), HDL-c, LDL-c, triglycerides (TG), VLDL-c, and non-HDL-c), kidney function (albumin/creatinine ratio (ACR) ≥30 and ≥300, cystatin C, serum creatinine and estimated glomerular filtration rate (eGFR)), systolic and diastolic blood pressure (BP) <i>z</i>-scores, BMI <i>z</i>-score, waist circumference (WC), and an inflammatory marker (C-reactive protein (CRP)). Models were stratified by diabetes type (type 1 diabetes (T1D), <i>N</i> = 4,600; type 2 diabetes (T2D), <i>N</i> = 932) and adjusted for age at diagnosis, sex, race/ethnicity, and diabetes duration. An interaction analysis assessed differential time trends by type.</p><p><strong>Results: </strong>For youth with T1D, all CRFs significantly improved over time, with the exception of ACR > 300, cystatin C, serum creatinine, eGFR, and CRP. For youth with T2D, TC, LDL-c, and non-HDL-c significantly improved, while eGFR, BMI <i>z</i>-score, and CRP significantly worsened. Significant differences in trends over time by type were seen for TC, HDL-c, BMI <i>z</i>-score, BP <i>z</i>-scores, WC, and CRP.</p><p><strong>Conclusions: </strong>Overall, improvements in CRFs were more often observed in youth with T1D. Youth with T2D had worsening trends over time in BMI <i>z</i>-score, CRP, and kidney function. Further research is needed to better understand these trends and their implications for long-term CVD risk.</p>","PeriodicalId":19797,"journal":{"name":"Pediatric Diabetes","volume":"2024 ","pages":"5213520"},"PeriodicalIF":3.9,"publicationDate":"2024-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12017249/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144016063","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rates, Risk Factors, and Progression of Diabetic Retinopathy in Children with Type 1 Diabetes: A 15-Year Retrospective Study from a Regional Center in New Zealand.","authors":"Thomas Winter, José G B Derraik, Craig A Jefferies, Paul L Hofman, James A D Shand, Geoffrey D Braatvedt, Stuti L Misra","doi":"10.1155/2024/5893771","DOIUrl":"https://doi.org/10.1155/2024/5893771","url":null,"abstract":"<p><strong>Aims: </strong>Diabetic retinopathy (DR) is the primary microvascular complication associated with diabetes. Evidence on DR prevalence among children in New Zealand is scarce. We examined DR rates and associated risk factors in youth with type 1 diabetes (T1D) aged <16 years receiving care from a regional diabetes service in January 2006-December 2020.</p><p><strong>Materials and methods: </strong>DR diagnosis followed the International Society for Pediatric and Adolescent Diabetes guidelines. The study included 646 participants; mean age (±SD) at T1D diagnosis was 7.4 ± 3.6 years, 47% were female, and 69% identified as NZ Europeans.</p><p><strong>Results: </strong>The initial DR screening occurred at a mean age of 12.6 ± 2.4 years and 5.2 ± 2.2 years after T1D diagnosis. At the first DR screen, 23.5% of participants (152/646) were diagnosed with DR: 69.1% (105/152) with minimal, 30.3% (46/152) with mild, and one moderate case (0.7%). Older age at diagnosis (<i>p</i>=0.029) and longer diabetes duration (<i>p</i>=0.015) were predictors of DR at first screen. Patients with at least one positive DR screen had a higher average HbA1c at their first screen (+2.6 mmol/mol; <i>p</i>=0.042). Overall, 55.6% (359/646) of patients had a positive DR screen, whose worst grade was mostly either minimal (58.2%) or mild (40.7%) DR, with only three moderate cases (0.8%) and one severe (0.3%). Children diagnosed with T1D before age 10 were 72% more likely to have DR than older children (<i>p</i> < 0.0001), and DR risk was 32% and 41% higher among Pacific children than NZ European (<i>p</i>=0.008) and Māori (<i>p</i>=0.014) children. Lastly, the only predictor of DR at discharge from paediatric services was HbA1c at the first screen (<i>p</i> < 0.0001).</p><p><strong>Conclusions: </strong>In this regional cohort of children with T1D, there was a high rate of low-grade DR overall and at first retinal screen, with an increasing rate until transfer to adult services. Our findings underscore the importance of ongoing DR screening, reducing glycaemic levels, and supporting vulnerable high-risk groups.</p>","PeriodicalId":19797,"journal":{"name":"Pediatric Diabetes","volume":"2024 ","pages":"5893771"},"PeriodicalIF":3.9,"publicationDate":"2024-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12020911/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144026828","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Insulin Resistance in Pediatric Obesity: From Mechanisms to Treatment Strategies.","authors":"Yu Luo, Dan Luo, Maojun Li, Binzhi Tang","doi":"10.1155/2024/2298306","DOIUrl":"10.1155/2024/2298306","url":null,"abstract":"<p><p>Insulin resistance, an increasingly prevalent characteristic among children and adolescents with obesity, is now recognized as a significant contributor to the development of type 2 diabetes mellitus (T2DM) and other metabolic diseases in individuals with obesity. Insulin resistance refers to a decrease in the sensitivity of peripheral tissues (primarily skeletal muscle, adipose tissue, and liver) to insulin, which is mainly characterized by impaired glucose uptake and utilization. Although the mechanisms underlying insulin resistance in children with obesity remain incompletely elucidated, several risk factors including lipid metabolism disorders, oxidative stress (OS), mitochondrial dysfunction, inflammation, and genetic factors have been identified as pivotal contributors to the pathogenesis of obesity-related insulin resistance. In this review, we comprehensively analyze relevant literature and studies to elucidate the underlying mechanisms of insulin resistance in childhood obesity. Additionally, we discuss treatment strategies for pediatric obesity from a perspective centered on improving insulin sensitivity, aiming to provide valuable insights for the prevention and management of pediatric obesity.</p>","PeriodicalId":19797,"journal":{"name":"Pediatric Diabetes","volume":"2024 ","pages":"2298306"},"PeriodicalIF":3.9,"publicationDate":"2024-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12016791/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144015968","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diabetes Complications among Inpatients with Childhood and Young Adult-Onset Type 1 and 2 Diabetes.","authors":"Kate Hawke, Soong Zheng Ng, Jessica Anderson, Raymond Dharmaputra, Prue Hogg, Angela Titmuss, Ashim Sinha, Anna McLean","doi":"10.1155/2024/9926090","DOIUrl":"https://doi.org/10.1155/2024/9926090","url":null,"abstract":"<p><strong>Aims: </strong>To assess morbidity among young people with diabetes presenting to a regional hospital in Northern Australia and compare the risk of complications among those living with type 2 diabetes (T2D) versus type 1 diabetes (T1D).</p><p><strong>Materials and methods: </strong>A cross-sectional study of young people with T1D or T2D (diagnosed age 1-25 years) presenting to a regional Northern Australian hospital with any condition from 2015 to 2019. Demographics, cardiometabolic comorbidities, and diabetes-related complications were collected from individual medical records and compared between those with T1D and T2D.</p><p><strong>Results: </strong>Among 357 young people (192 had T2D, 165 T1D), the mean age was 22 years, the mean duration of diabetes was 6.7 years, 52% were Aboriginal or Torres Strait Islander, and 28% lived remotely. Cardiometabolic comorbidities (obesity, hypertension, and dyslipidaemia) and diabetes-related complications (microalbuminuria, amputation, and elevated non-alcoholic fatty liver disease score) were more prevalent in those with T2D compared to T1D, despite shorter disease duration and lower median HbA1c. When adjusted for age, sex, and BMI, the odds ratio (95% CI) for microalbuminuria was 4.8 (1.83-12.8) with T2D compared to T1D.</p><p><strong>Conclusion: </strong>In a cohort of young people with diabetes in Northern Australia, the prevalence of diabetes-related complications was higher among those with T2D than T1D.</p>","PeriodicalId":19797,"journal":{"name":"Pediatric Diabetes","volume":"2024 ","pages":"9926090"},"PeriodicalIF":3.9,"publicationDate":"2024-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12016798/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144019739","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trends in the Incidence of Type 1 Diabetes in European Children and Adolescents from 1994 to 2022: A Systematic Review and Meta-Analysis.","authors":"Marta Carolina Ruiz-Grao, Ana Díez-Fernández, Arthur E Mesas, Vicente Martínez-Vizcaíno, Irene Sequí-Domínguez, Fernando Sebastián-Valles, Miriam Garrido-Miguel","doi":"10.1155/2024/2338922","DOIUrl":"https://doi.org/10.1155/2024/2338922","url":null,"abstract":"<p><strong>Aim: </strong>To assess the incidence trends in type 1 diabetes among children and adolescents across Europe during the period from 1994 to 2022 using a systematic methodology.</p><p><strong>Materials and methods: </strong>Cross-sectional or follow-up studies reporting population-based incidence rates (IRs) of European children and adolescents diagnosed aged <15 years with type 1 diabetes were included. The Mantel‒Haenszel or DerSimonian and Laird random-effects method was used to compute the pooled IR estimates and their 95% confidence intervals (CIs). Subgroup analyses were conducted by study year, biological sex, age group (0-4, 5-9, and 10-14 years), country, and European regions.</p><p><strong>Results: </strong>A total of 75 studies (219,331 children and adolescents aged 0-14 years) with data from 32 countries were included. Generally, a high overall rate of increase in type 1 diabetes incidence has been shown in most European countries from 1994 to 2022 in both sexes, with an overall increase from 10.85 (95% CI, 9.62-12.07) per 100,000 person-years from 1994 to 2003 to 20.96 (95% CI, 19.26-22.66) per 100,000 person-years from 2013 to 2022.</p><p><strong>Conclusions: </strong>There are substantial between-country differences in the current levels and trends of IR in type 1 diabetes in European children and adolescents. Our data suggest a worrying upward trend in most European countries.</p>","PeriodicalId":19797,"journal":{"name":"Pediatric Diabetes","volume":"2024 ","pages":"2338922"},"PeriodicalIF":3.9,"publicationDate":"2024-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12020782/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143993653","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Elevated Serum IgA at Onset of Type 1 Diabetes in Children.","authors":"Amruta Thakkar, Xiaofan Huang, Johnny Wang, Kathy Hwu, Ivan K Chinn, Charles Minard, Joud Hajjar, Maria J Redondo","doi":"10.1155/2024/7284088","DOIUrl":"https://doi.org/10.1155/2024/7284088","url":null,"abstract":"<p><strong>Background: </strong>Elevated serum IgA levels have been observed in various autoimmune conditions, including type 1 diabetes (T1D). However, whether children with T1D and elevated serum IgA have unique features has not been studied. We aimed to evaluate the prevalence and characteristics associated with elevated serum IgA at the onset of pediatric T1D.</p><p><strong>Materials and methods: </strong>We analyzed demographic, clinical, and laboratory data retrospectively collected from 631 racially diverse children (6 months-18 years of age) with T1D who had serum IgA levels measured within 90 days of T1D diagnosis. Univariable and multivariable logistic regression models were used to identify characteristics that were significantly associated with elevated versus normal IgA.</p><p><strong>Results: </strong>Elevated serum IgA was present in 20.3% (128/631) of the children with newly diagnosed T1D. After adjusting for other variables, A1c level (<i>p</i>=0.029), positive insulin autoantibodies (IAA) (<i>p</i>=0.041), negative glutamic acid decarboxylase autoantibodies (GADA) (<i>p</i>=0.005) and Hispanic ethnicity (<i>p</i>  < 0.001) were significantly associated with elevated serum IgA. After adjustment for confounders, the odds of elevated serum IgA were significantly increased with positive IAA (OR 1.653, 95% CI 1.019-2.679), higher HbA1c (OR 1.132, 95% CI 1.014-1.268) and Hispanic ethnicity (OR 3.279, 95% CI 2.003-5.359) but decreased with GADA positivity (OR 0.474, 95% CI 0.281-0.805).</p><p><strong>Conclusions: </strong>Elevated serum IgA is present in 20.3% of the children at T1D onset and is associated with specific demographic and clinical characteristics, suggesting a unique pathogenesis in a subset of individuals. Further studies are warranted to investigate the IgA response, its role in T1D pathogenesis, and whether these associations persist over time.</p>","PeriodicalId":19797,"journal":{"name":"Pediatric Diabetes","volume":"2024 ","pages":"7284088"},"PeriodicalIF":3.9,"publicationDate":"2024-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12016712/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143976375","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Detection of Islet Autoantibodies in Whole Blood by Antibody Detection by Agglutination-PCR (ADAP) Technology Is Sensitive and Suitable for General Population Screening Programs.","authors":"Tal Oron, Felipe de Jesus Cortez, Biana Shtaif, Peter V Robinson, Michal Yackobovitch-Gavan, Devangkumar Tandel, David Seftel, Moshe Phillip, Cheng-Ting Tsai, Galia Gat-Yablonski","doi":"10.1155/2024/4238394","DOIUrl":"https://doi.org/10.1155/2024/4238394","url":null,"abstract":"<p><strong>Background: </strong>Detection of type 1 diabetes (T1D) at the preclinical stage is possible by detecting islet autoantibodies (IAs) years before the appearance of symptomatic diabetes. The Antibody Detection Israeli Research is a general population screening program searching for children with multiple IAs who are at risk of developing T1D. IAs are measured in capillary or venous whole blood (WB) samples using the novel ultrasensitive antibody detection by agglutination-PCR (ADAP) technology.</p><p><strong>Objective: </strong>To assess the accuracy and reliability of the ADAP assay in venous and capillary WB.</p><p><strong>Materials and methods: </strong>In total, 50 children with T1D and 50 healthy controls participated in the study. Venous and capillary blood samples were drawn from participants with T1D, while only venous blood was drawn from the controls. The ADAP assay in venous and capillary blood was compared to the currently used assays in their ability to detect glutamic acid decarboxylase (GADA), islet antigen-2 (IA-2A), and insulin autoantibodies (IAAs).</p><p><strong>Results: </strong>The area under the curve using the receiver operating characteristic curves was comparable between the ADAP assay in WB and standard enzyme-linked immunosorbent assay (ELISA)/radioimmunoassay (RIA) for all three IAs GADA 0.946 (95% CI: 0.900-0.991) vs. 0.949 (0.906-0.992), <i>P</i>=0.873; IA-2A 0.747 (0.649-0.844) vs. 0.666 (0.587-0.744), <i>P</i>=0.106; IAA 1.000 (1.000-1.000) vs. 1.000 (1.000-1.000), <i>P</i>=1.000. The correlation between the levels of IA in venous and capillary WB using ADAP was <i>R</i> ² = 0.958 (<i>P</i>  < 0.01), <i>R</i> ² = 0.943 (<i>P</i>  < 0.01), and <i>R</i> ² = 0.711 (<i>P</i>  < 0.01) for GADA, IA-2A, and IAA, respectively. IA levels in venous and capillary WB using ADAP were comparable without a proportional bias in Bland-Altman's plots of agreement, suggesting the two methods may be used interchangeably.</p><p><strong>Conclusions: </strong>The ADAP assay is reliable in detecting IA in venous and capillary WB samples with comparable performance to standard RIA and ELISA. These findings open avenues for widespread use of the ADAP assay in future general population screening programs to detect children at risk of developing T1D.</p>","PeriodicalId":19797,"journal":{"name":"Pediatric Diabetes","volume":"2024 ","pages":"4238394"},"PeriodicalIF":3.9,"publicationDate":"2024-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12016989/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143973325","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}