Type 1 Diabetes Genetic Risk in 109,954 Veterans With Adult-Onset Diabetes : The Million Veteran Program (MVP)
© 2024 by the American Diabetes Association..
OBJECTIVE: To characterize high type 1 diabetes (T1D) genetic risk in a population where type 2 diabetes (T2D) predominates.
RESEARCH DESIGN AND METHODS: Characteristics typically associated with T1D were assessed in 109,594 Million Veteran Program participants with adult-onset diabetes, 2011-2021, who had T1D genetic risk scores (GRS) defined as low (0 to <45%), medium (45 to <90%), high (90 to <95%), or highest (≥95%).
RESULTS: T1D characteristics increased progressively with higher genetic risk (P < 0.001 for trend). A GRS ≥ 90% was more common with diabetes diagnoses before age 40 years, but 95% of those participants were diagnosed at age ≥40 years, and they resembled T2D in mean age (64.3 years) and BMI (32.3 kg/m2). Compared with the low risk group, the highest-risk group was more likely to have diabetic ketoacidosis (low 0.9% vs. highest GRS 3.7%), hypoglycemia prompting emergency visits (3.7% vs. 5.8%), outpatient plasma glucose <50 mg/dL (7.5% vs. 13.4%), a shorter median time to start insulin (3.5 vs. 1.4 years), use of a T1D diagnostic code (16.3% vs. 28.1%), low C-peptide levels if tested (1.8% vs. 32.4%), and glutamic acid decarboxylase antibodies (6.9% vs. 45.2%), all P < 0.001.
CONCLUSIONS: Characteristics associated with T1D were increased with higher genetic risk, and especially with the top 10% of risk. However, the age and BMI of those participants resemble people with T2D, and a substantial proportion did not have diagnostic testing or use of T1D diagnostic codes. T1D genetic screening could be used to aid identification of adult-onset T1D in settings in which T2D predominates.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2024 |
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| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - year:2024 |
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| Enthalten in: |
Diabetes care - (2024) vom: 12. Apr. |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Yang, Peter K [VerfasserIn] |
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| Links: |
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| Themen: |
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| Anmerkungen: |
Date Revised 12.04.2024 published: Print-Electronic Citation Status Publisher |
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| doi: |
10.2337/dc23-1927 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM370975804 |
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| 024 | 7 | |a 10.2337/dc23-1927 |2 doi | |
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| 035 | |a (DE-627)NLM370975804 | ||
| 035 | |a (NLM)38608262 | ||
| 035 | |a (PII)dc231927 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Yang, Peter K |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Type 1 Diabetes Genetic Risk in 109,954 Veterans With Adult-Onset Diabetes |b The Million Veteran Program (MVP) |
| 264 | 1 | |c 2024 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Revised 12.04.2024 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status Publisher | ||
| 520 | |a © 2024 by the American Diabetes Association. | ||
| 520 | |a OBJECTIVE: To characterize high type 1 diabetes (T1D) genetic risk in a population where type 2 diabetes (T2D) predominates | ||
| 520 | |a RESEARCH DESIGN AND METHODS: Characteristics typically associated with T1D were assessed in 109,594 Million Veteran Program participants with adult-onset diabetes, 2011-2021, who had T1D genetic risk scores (GRS) defined as low (0 to <45%), medium (45 to <90%), high (90 to <95%), or highest (≥95%) | ||
| 520 | |a RESULTS: T1D characteristics increased progressively with higher genetic risk (P < 0.001 for trend). A GRS ≥ 90% was more common with diabetes diagnoses before age 40 years, but 95% of those participants were diagnosed at age ≥40 years, and they resembled T2D in mean age (64.3 years) and BMI (32.3 kg/m2). Compared with the low risk group, the highest-risk group was more likely to have diabetic ketoacidosis (low 0.9% vs. highest GRS 3.7%), hypoglycemia prompting emergency visits (3.7% vs. 5.8%), outpatient plasma glucose <50 mg/dL (7.5% vs. 13.4%), a shorter median time to start insulin (3.5 vs. 1.4 years), use of a T1D diagnostic code (16.3% vs. 28.1%), low C-peptide levels if tested (1.8% vs. 32.4%), and glutamic acid decarboxylase antibodies (6.9% vs. 45.2%), all P < 0.001 | ||
| 520 | |a CONCLUSIONS: Characteristics associated with T1D were increased with higher genetic risk, and especially with the top 10% of risk. However, the age and BMI of those participants resemble people with T2D, and a substantial proportion did not have diagnostic testing or use of T1D diagnostic codes. T1D genetic screening could be used to aid identification of adult-onset T1D in settings in which T2D predominates | ||
| 650 | 4 | |a Journal Article | |
| 700 | 1 | |a Jackson, Sandra L |e verfasserin |4 aut | |
| 700 | 1 | |a Charest, Brian R |e verfasserin |4 aut | |
| 700 | 1 | |a Cheng, Yiling J |e verfasserin |4 aut | |
| 700 | 1 | |a Sun, Yan V |e verfasserin |4 aut | |
| 700 | 1 | |a Raghavan, Sridharan |e verfasserin |4 aut | |
| 700 | 1 | |a Litkowski, Elizabeth M |e verfasserin |4 aut | |
| 700 | 1 | |a Legvold, Brian T |e verfasserin |4 aut | |
| 700 | 1 | |a Rhee, Mary K |e verfasserin |4 aut | |
| 700 | 1 | |a Oram, Richard A |e verfasserin |4 aut | |
| 700 | 1 | |a Kuklina, Elena V |e verfasserin |4 aut | |
| 700 | 1 | |a Vujkovic, Marijana |e verfasserin |4 aut | |
| 700 | 1 | |a Reaven, Peter D |e verfasserin |4 aut | |
| 700 | 1 | |a Cho, Kelly |e verfasserin |4 aut | |
| 700 | 1 | |a Leong, Aaron |e verfasserin |4 aut | |
| 700 | 1 | |a Wilson, Peter W F |e verfasserin |4 aut | |
| 700 | 1 | |a Zhou, Jin |e verfasserin |4 aut | |
| 700 | 1 | |a Miller, Donald R |e verfasserin |4 aut | |
| 700 | 1 | |a Sharp, Seth A |e verfasserin |4 aut | |
| 700 | 1 | |a Staimez, Lisa R |e verfasserin |4 aut | |
| 700 | 1 | |a North, Kari E |e verfasserin |4 aut | |
| 700 | 1 | |a Highland, Heather M |e verfasserin |4 aut | |
| 700 | 1 | |a Phillips, Lawrence S |e verfasserin |4 aut | |
| 700 | 0 | |a Million Veteran Program |e verfasserin |4 aut | |
| 700 | 1 | |a Muralidhar, Sumitra |e investigator |4 oth | |
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