Prediction Models for Diabetes in Children and Adolescents: A Review

Applied Sciences, Journal Year: 2025, Volume and Issue: 15(6), P. 2906 - 2906

Published: March 7, 2025

This review aims to present the latest advancements in prediction models for diabetes mellitus, with a particular focus on children and adolescents. It highlights predicting both type 1 2 this population, emphasizing inclusion of risk factors that facilitate identification potential occurrence early detection young individuals. Newly identified differentiating between types are discussed, alongside an overview various machine learning deep algorithms specifically adapted The advantages limitations these methods critically examined. underscores necessity addressing challenges posed by incomplete datasets emphasizes importance creating comprehensive data repository. Such developments essential enabling artificial intelligence tools generate suitable broad clinical application advancing diagnostic preventive strategies

Language: Английский

---

Type 1 diabetes presenting in adults: Trends, diagnostic challenges and unique features

Diabetes Obesity and Metabolism, Journal Year: 2025, Volume and Issue: unknown

Published: April 15, 2025

Abstract Type 1 diabetes (T1D) has been historically regarded as a childhood‐onset disease; however, recent epidemiological data indicate that adult‐onset T1D accounts for substantial proportion of cases worldwide. There is evidence associated with the classic triad elevated genetic risk, presence islet‐specific autoantibodies and progression to severe insulin deficiency. In this article, we review our understanding commonalities differences between childhood T1D, highlight significant knowledge gaps in diagnosis, incidence, trajectory treatment T1D. Compared children, adults presenting exhibit immunologic profiles metabolic outcomes, including type number present, associations total burden, rates C‐peptide decline, persistence long‐duration disease glycaemic control. addition, obesity syndrome are increasingly common adults, which not only blurs clinical distinction from 2 (T2D) but also likely contributes outcomes progression. Because T2D so prevalent adult population, misclassified at least one three cases, leading delays appropriate treatment. Current diagnostic tools, autoantibody testing measurement, underutilised or lack specificity distinguishing atypical T2D. Additionally, impact different responses disease‐modifying therapy children unclear. Addressing these requires expanded studies, diverse patient registries refined classification criteria improve early detection strategies. A deeper will be critical reduce burden misdiagnosis, lead earlier diagnosis optimise population‐based screening approaches under‐recognised population. Plain Language Summary an autoimmune causes nutritional complications due destruction insulin‐producing pancreatic β cells. was formerly known “juvenile diabetes” because it assumed most occurred childhood; show nearly half all diagnosed adulthood. Despite high prevalence there challenges correctly diagnosing adulthood, remain regarding trajectory, summarize current Particularly, age‐related profiles, complications. Finally, key need addressed misdiagnosis allow better

Language: Английский

---

Algorithms to define diabetes type using data from administrative databases: A systematic review of the evidence

Diabetes Research and Clinical Practice, Journal Year: 2023, Volume and Issue: 203, P. 110859 - 110859

Published: July 29, 2023

Language: Английский

---

Clinical Prediction Models Combining Routine Clinical Measures Have High Accuracy in Identifying Youth-Onset Type 2 Diabetes Defined by Maintained Endogenous Insulin Secretion: The SEARCH for Diabetes in Youth Study

Diabetes Care, Journal Year: 2024, Volume and Issue: unknown

Published: Jan. 22, 2024

OBJECTIVE With high prevalence of obesity and overlapping features between diabetes subtypes, accurately classifying youth-onset can be challenging. We aimed to develop prediction models that, using characteristics available at diagnosis, identify youth who will retain endogenous insulin secretion levels consistent with type 2 (T2D). RESEARCH DESIGN AND METHODS studied 2,966 in the prospective SEARCH for Diabetes Youth study (diagnosis age ≤19 years) participants fasting C-peptide ≥250 pmol/L (≥0.75 ng/mL) after >3 years’ (median 74 months) duration. Models included clinical measures baseline visit, a mean duration 11 months (age, BMI, sex, waist circumference, HDL cholesterol), without islet autoantibodies (GADA, IA-2A) Type 1 Genetic Risk Score (T1DGRS). RESULTS routine or T1DGRS were highly accurate identifying ≥0.75 ng/mL (17% participants; 2.3% 53% those positive autoantibodies) (area under receiver operating characteristic curve [AUCROC] 0.95–0.98). In internal validation, optimism was very low, excellent calibration (slope 0.995–0.999). retained performance predicting older (AUCROC 0.88–0.96) subgroups defined by self-reported race/ethnicity 0.88–0.97), autoantibody status 0.87–0.96), clinically diagnosed types 0.81–0.92). CONCLUSIONS Prediction combining T1DGRS, maintain range associated T2D.

Language: Английский

---

Investigating misclassification of type 1 diabetes in a population-based cohort of British Pakistanis and Bangladeshis using polygenic risk scores

medRxiv (Cold Spring Harbor Laboratory), Journal Year: 2023, Volume and Issue: unknown

Published: Aug. 25, 2023

Abstract Aims Correct classification of type 1 (T1D) and 2 diabetes (T2D) is challenging due to overlapping clinical features the increasingly early onset T2D, particularly in South Asians. We used polygenic risk scores (PRSs) a British Bangladeshi Pakistani population with estimate proportion misclassification rate T1D insulin-treated individuals ambiguous features. Methods Using linked health records from Genes & Health cohort (n=38,344) we defined four groups: 31 cases, 1,842 T2D after excluding these, 839 5,174 controls. Combining these 307 confirmed cases controls India, calculated ancestry-corrected PRSs for which estimated within group evaluated misclassification. Results that prevalence was ∼6% group, or ∼4.5% subset who had codes their records. saw no significant association between PRS BMI at diagnosis, time insulin, presence diagnostic amongst suggesting are not helpful aiding diagnosis cases. Conclusions about one twenty Pakistanis Bangladeshis treated insulin have been classified incorrectly records, fact T1D. This emphasises robust identification appropriate care may require routine measurement autoantibodies C-peptide. Research context What already known this subject? - people Asian descent. Polygenic useful tools aid diabetes. key question? diabetic clinically misclassified T1D, adults? new findings? Based on analyses scores, found be patients were but features, misclassified. Clinical such as T1D/T2D significantly associated PRS. How might impact practice foreseeable future? These findings emphasise importance collection C-peptide measurements identify robustly, especially countries where diagnosed primary without input diabetologists.

Language: Английский

---

Treatment outcomes with oral anti-hyperglycaemic therapies in people with diabetes secondary to a pancreatic condition (type 3c diabetes): A population-based cohort study

medRxiv (Cold Spring Harbor Laboratory), Journal Year: 2024, Volume and Issue: unknown

Published: Aug. 1, 2024

Objectives Diabetes secondary to a pancreatic condition (type 3c diabetes) affects 5-10% of people with diabetes, but evidence on the efficacy and tolerability oral therapies in this group are lacking. We aimed assess short-term treatment outcomes anti-hyperglycaemic type diabetes. Design Population-based cohort study. Setting UK primary care records (Clinical Practice Research Datalink; 2004-2020), linked hospital records. Participants 7,084 (acute pancreatitis, chronic cancer, haemochromatosis) preceding diabetes diagnosis cohort) initiating an glucose-lowering therapy (metformin, sulphonylureas, SGLT2-inhibitors, DPP4-inhibitors, or thiazolidinediones [TZDs]), without concurrent insulin treatment. This was stratified by exocrine insufficiency [PEI] (1,167 PEI, 5,917 without) matched 97,227 2 (T2D) controls. Main outcome measures 12-month HbA1c change discontinuation within 6 months, compared T2D Results People had substantial mean reduction those PEI (9.4 mmol/mol [95%CI 8.9 10.0]) (12.2 [12.0 12.4]). Compared controls, similar (0.7 [0.4 1.0] difference) odds early (Odds ratio [OR] 1.08 [0.98 1.19]). In contrast, lower response (3.5 [2.9 4.1] lesser reduction), greater (OR 2.03 [1.73 2.36]). were largely consistent across subtypes individual drug classes. Conclusions Oral effective could provide important component glycaemic management. However, presence is associated modestly reduced tolerability, meaning identify that may benefit from closer monitoring after therapy.

Language: Английский

---

Type 1 diabetes genetic risk score variation across ancestries using whole genome sequencing and array-based approaches

Scientific Reports, Journal Year: 2024, Volume and Issue: 14(1)

Published: Dec. 28, 2024

Abstract A Type 1 Diabetes Genetic Risk Score (T1DGRS) aids diagnosis and prediction of (T1D). While traditionally derived from imputed array genotypes, Whole Genome Sequencing (WGS) provides a more direct approach is now increasingly used in clinical research studies. We investigated the concordance between WGS-based array-based T1DGRS across genetic ancestries 149,265 UK Biobank participants using WGS, TOPMed-imputed, 1000 Genomes-imputed genotypes. In overall cohort, demonstrated strong correlation with TOPMed-imputed score ( r = 0.996, average 0.0028 standard deviations (SD) lower, p < 10 − 31 ), while showing lower scores 0.981, 0.043 SD 300 ). Ancestry-stratified analyses showed highest European ancestry 0.044 ) followed by African 0.989, 0.0193 14 South Asian 0.986, 0.0129 6 These differences were pronounced when comparing WGS based 0.982, 0.975, 0.957 for European, Asian, respectively). Population-level analysis revealed significant ancestry-based stratification, individuals scores, (average 0.28 than Europeans, 58 0.89 Notably, applying ancestry-derived 90 th centile risk threshold, only 0.71% (95% CI 0.41–1.13) 6.4% 5.6–7.2) identified as high-risk, substantially below expected 10%. conclusion, viable generating T1DGRS, genotypes offering cost-effective alternative, persistence variations distribution even whole genome sequencing emphasises need ancestry-specific or pan-ancestry standards practice.

Language: Английский

---

Cause‐specific death in adults with type 1 diabetes and type 2 diabetes: Insights from the UK Biobank

Diabetes Obesity and Metabolism, Journal Year: 2024, Volume and Issue: unknown

Published: Oct. 14, 2024

Muthiah Vaduganathan has received research grant support, served on advisory boards, or had speaker engagements with American Regent, Amgen, AstraZeneca, Bayer AG, Baxter Healthcare, BMS, Boehringer Ingelheim, Chiesi, Cytokinetics, Lexicon Pharmaceuticals, Merck, Novartis, Novo Nordisk, Pharmacosmos, Relypsa, Roche Diagnostics, Sanofi, and Tricog Health, participates clinical trial committees for studies sponsored by Galmed, Occlutech, Impulse Dynamics. Michael C. Honigberg reports board service Miga Health; receiving personal fees from Comanche Biopharma; serving as site principal investigator Novartis; grants the National Heart, Lung, Blood Institute, Heart Association, Patient-Centered Outcomes Research Genentech outside submitted work. John W. Ostrominski So Mi Jemma Cho have no disclosures to report. The peer review history this article is available at https://www.webofscience.com/api/gateway/wos/peer-review/10.1111/dom.16009. UK Biobank data are application (https://www.ukbiobank.ac.uk/register-apply/).

Language: Английский

---

Bioinformatic and rare‐variant collapsing analyses for type 1 and type 2 diabetes in the UK Biobank reveal novel pleiotropic susceptibility loci

Journal of Diabetes, Journal Year: 2023, Volume and Issue: 15(9), P. 799 - 802

Published: Aug. 1, 2023

Type 1 diabetes (T1D) is a chronic condition caused by the autoimmune destruction of pancreatic β-cells.1 In contrast, type 2 (T2D) characterized impaired glucose metabolism arising from defects in insulin resistance and secretion.2 More than 75 genetic loci influencing T1D risk have been identified.1 Genome-wide association studies (GWAS) T2D identified over 700 loci.2 Whole exome sequencing (WES) may reveal rare variants to common diseases such as T2D. However, only few large-scale WES published until Wang et al reported relationships between protein-coding 17 361 binary phenotypes using data 269 171 UK Biobank participants (https://azphewas.com/).3 Recently, Karczewski determined gene-based investigating 4529 394 841 exomes (https://app.genebass.org/).4 We used two portals (https://azphewas.com/ https://app.genebass.org/)3, 4 access gene collapsing analyses variation for (Table 1). Ethical statements are not required study no human or animal involved. order discard potential candidate genes we present with p values <.05/20000 = 2.5 × 10−6 commonly studies. Identified were bioinformatically analyzed GWAS catalog (https://www.ebi.ac.uk/gwas/), OMIM (https://www.omim.org/), Genecards (https://www.genecards.org/).5-8 The literature was searched https://pubmed.ncbi.nlm.nih.gov/. compared union same three-digit ICD-10 codes (International Classification Diseases, Tenth Revision).3, Table genome wide significant results shown most model. One previously linked (HLA-DRB5) four novel (PSMB9, NELFE, SLC44A4, VWA7) identified. For (GCK, HNF1A, HNF4A, ANKH) confirmed. addition, GIGYF1 has recently already Biobank.9 Two associations identified, DENND6A RPS3A genes. specific each Phenome-wide (PheWAS) 1) could link all five other immune-mediated diseases: ankylosing spondylitis, iridocyclitis, hypothyroidism, asthma, celiac disease, sarcoidosis, psoriasis, rheumatoid arthritis Thus, pleiotropic contribute observed epidemiological diseases.10 Only among associated disorder (hypothyroidism) even more interesting obstructive pulmonary disease (COPD) PheWAS analysis COPD recognized be conditions shared environmental exposures.11 Treatment antihyperglycemic drugs glucagon-like peptide (receptor agonists sodium transporter inhibitors reduced severe exacerbations patients T2D.12 might open treatments COPD. A limitation that validity perfect Biobank. diagnosis still useful research large papers about suggesting research: one Lancet Diabetes & Endocrinology Medicine.13, 14 Moreover, an article Thomas accuracy tested different methods range 71% 88%.15 These articles line findings study. instance, confirmed ANKH). definition differentiate known genes, which reassuring. (one old genes) bioinformatic disorders (Tables 2). It well links many exist.10 there overlap (ie, hypothyroidism). believe acceptable genetics conclusion, variations 12 (six novel) Biobank, (five (seven genes). contributes general population. Rare also whereas thank free Genebass AstraZeneca made this work possible https://app.genebass.org).3, This supported grant awarded Dr Bengt Zöller ALF-funding Region Skåne, Sparbanken Swedish Research Council. funders had role

Language: Английский

---