OBJECTIVE: To explore the relationship between family history of diabetes and frequency of diabetic ketoacidosis (DKA) at diagnosis and to analyze the possible association between HLA genotypes and DKA. DESIGN AND METHODS: We recruited 510 children and adolescents aged <17 years with type 1 diabetes (T1D) and collected information on first-degree relative (FDR) history of T1D. DKA and severe DKA were defined as blood pH <7.30 and <7.10 at diabetes onset respectively. Risk categories for developing T1D were determined according to various HLA DQA1-DQB1 haplotype combination genotypes. RESULTS: The frequency of DKA and severe DKA at diagnosis was 34.7 and 7.2% respectively. DKA was more frequent in younger patients (<2 years (60.0%; P<0.001)) and occurred less in children with at least one FDR affected by T1D (13.0 vs 37.4%, P<0.001). The logistic regression showed that age at diagnosis (<2 years) and increased HLA-associated risk genotypes were independent predictors of DKA (P<0.01, odds ratio (OR)=1.068 (95% confidence interval (CI) 1.021-1.117); P<0.05, OR=1.606 (95% CI 1.034-2.475)). Introducing the presence of T1D in at least one FDR in the logistic model, a significant association between DKA and age at diagnosis (<2 years; P<0.01, OR=1.072 (95% CI 1.024-1.123)) and absence of FDRs with T1D (P=0.001, OR=4.287 (95% CI 1.770-10.383)) was found, but no more with increased HLA-associated risk genotype (P=0.06, OR=1.550 (95% CI 0.992-2.423)). CONCLUSIONS: HLA-associated high-risk genotypes are associated with a high chance of presenting DKA at diabetes onset. However, having at least one FDR with T1D reduced the risk of DKA regardless of HLA genotype.
OBJECTIVE: To explore the relationship between family history of diabetes and frequency of diabetic ketoacidosis (DKA) at diagnosis and to analyze the possible association between HLA genotypes and DKA. DESIGN AND METHODS: We recruited 510 children and adolescents aged <17 years with type 1 diabetes (T1D) and collected information on first-degree relative (FDR) history of T1D. DKA and severe DKA were defined as blood pH <7.30 and <7.10 at diabetes onset respectively. Risk categories for developing T1D were determined according to various HLA DQA1-DQB1 haplotype combination genotypes. RESULTS: The frequency of DKA and severe DKA at diagnosis was 34.7 and 7.2% respectively. DKA was more frequent in younger patients (<2 years (60.0%; P<0.001)) and occurred less in children with at least one FDR affected by T1D (13.0 vs 37.4%, P<0.001). The logistic regression showed that age at diagnosis (<2 years) and increased HLA-associated risk genotypes were independent predictors of DKA (P<0.01, odds ratio (OR)=1.068 (95% confidence interval (CI) 1.021-1.117); P<0.05, OR=1.606 (95% CI 1.034-2.475)). Introducing the presence of T1D in at least one FDR in the logistic model, a significant association between DKA and age at diagnosis (<2 years; P<0.01, OR=1.072 (95% CI 1.024-1.123)) and absence of FDRs with T1D (P=0.001, OR=4.287 (95% CI 1.770-10.383)) was found, but no more with increased HLA-associated risk genotype (P=0.06, OR=1.550 (95% CI 0.992-2.423)). CONCLUSIONS: HLA-associated high-risk genotypes are associated with a high chance of presenting DKA at diabetes onset. However, having at least one FDR with T1D reduced the risk of DKA regardless of HLA genotype.
Authors: Craig Jefferies; Samuel W Cutfield; José G B Derraik; Jignal Bhagvandas; Benjamin B Albert; Paul L Hofman; Alistair J Gunn; Wayne S Cutfield Journal: Sci Rep Date: 2015-05-19 Impact factor: 4.379
Authors: Leonardo Calil Vicente Franco de Souza; Gabriela de Carvalho Kraemer; Adriana Koliski; José Eduardo Carreiro; Mônica Nunes Lima Cat; Luiz De Lacerda; Suzana Nesi França Journal: Rev Paul Pediatr Date: 2019-11-25
Authors: Stefano Zucchini; Andrea E Scaramuzza; Riccardo Bonfanti; Pietro Buono; Francesca Cardella; Vittoria Cauvin; Valentino Cherubini; Giovanni Chiari; Giuseppe d'Annunzio; Anna Paola Frongia; Dario Iafusco; Giulio Maltoni; Ippolita Patrizia Patera; Sonia Toni; Stefano Tumini; Ivana Rabbone Journal: J Diabetes Res Date: 2015-11-15 Impact factor: 4.011
Authors: Elizabeth T Jensen; Jeanette M Stafford; Sharon Saydah; Ralph B D'Agostino; Lawrence M Dolan; Jean M Lawrence; Santica Marcovina; Elizabeth J Mayer-Davis; Catherine Pihoker; Arleta Rewers; Dana Dabelea Journal: Diabetes Care Date: 2021-06-07 Impact factor: 17.152