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Tool to gauge glycemic progression toward type 1 diabetes could boost prevention, biomarker evaluation
A scale that shows 6-month glycemic progression toward type 1 diabetes in autoantibody-positive relatives of individuals with the condition could help assess preventative treatments and biomarkers, according to research published in Diabetes Care.
The PS6M — developed from Diabetes Prevention Trial Type 1 Study Group data and validated in the TrialNet Pathway to Prevention Study — reflects the difference between 6-month glucose sum values and values projected for individuals who do not develop type 1 diabetes.
“It was a far better predictor of type 1 diabetes than the difference in glucose values between the oral glucose tolerance tests,” the researchers wrote. “The PS6M acts as a frame of reference for progression toward type 1 diabetes because it is based on the expected 6-month glucose sum values of nonprogressors.”
Jay M. Sosenko
Jay M. Sosenko, MD, in the division of endocrinology, University of Miami, Florida, and colleagues from other institutions developed the scale with 6-month glucose sum values based on 30- to 120-minute oral glucose tolerance tests.
The researchers obtained a second scale based on nonprogressors in the Pathway to Prevention Study, then compared both scales within the full study population of progressors and nonprogressors.
The PS6M strongly predicted type 1 diabetes in the PTP (P < .001). The area under the receiver operating characteristic curve was greater (P < .001) for the PS6M compared with the 6-month difference sums.
PS6M values were higher in individuals with at least two autoantibodies, C-peptide values below 2 ng/mL (30-0 minutes) or Diabetes Prevention Trial Type 1 risk scores above 7 (P < .001 for all). These results indicate the PS6M could be used to gauge the influence of biomarkers on short-term glycemic changes, according to the researchers.
“Although highly predictive, the PS6M is not a diagnostic surrogate for type 1 diabetes per se,” the researchers wrote. “Rather, it would indicate the effect of an intervention on the glycemic progression toward type 1 diabetes.” – by Allegra Tiver
Disclosure: The researchers report no relevant financial disclosures.