Ped endo journal scan

Objective:The objective of this study was to assess whether clinically diagnosed type 1 diabetes (T1D) occurring in children and young adults from sub-Saharan Africa is of autoimmune origin and whether the phenotype and genetic susceptibility differ from T1D in other populations. Study Methodology and Results:This was an observational, cross-sectional study (Young-Onset Diabetes in sub-Saharan Africa [YODA]), which included participants from Cameroon, Uganda, and South Africa who were of self-reported Black African ethnicity and had been clinically diagnosed with T1D at younger than 30 years of age and treated with insulin.The study included data from Black South African participants from a previous multicenter T1D study.Islet autoantibodies to glutamic acid decarboxylase (GADA), islet cell antigen-2 (IA-2A), and zinc transporter 8 (ZnT8A) were analyzed along with assessment of random C-peptide levels.Genetic susceptibility to T1D was assessed using a genetic risk score (GRS).Genetic data were compared to genotype array data from population controls from Uganda, Cameroon, and Black South Africans.The findings from the study were compared with data from participants from the SEARCH for Diabetes in Youth (SEARCH) study in the USA.The study enrolled 1072 participants, of which 894 were included in the analysis.The median duration of diabetes at the time of study was 5 years (interquartile range [IQR] 2-10), and 440 (49.2%) of 894 participants were female.The median age at diagnosis was 15 years (IQR 11-19), with a body mass index (BMI) of 21.7 kg/m (19.5-24.1).Most participants (573 [71.6%] of 800) had severe insulin deficiency (plasma C-peptide <200 pmol/L).The majority (582 [65.1%] of 894) of participants from the sub-Saharan Africa cohorts were negative for islet autoantibodies.Even 'among' the participants within 1 year of diabetes diagnosis (n = 143), 84 (58.0%) were still islet autoantibody negative.GADA was by far the most prevalent islet autoantibody across the sub-Saharan African cohorts (258 [28.8%] of 894), followed by ZnT8A (86 [9.6%] of 894), and IA-2A (69 [7.7%] of 894).Islet autoantibody-positive participants had low endogenous insulin secretion, with 225 (82.7%) of 272 having plasma C-peptide concentrations of <200 pmol/L and a high genetic susceptibility to T1D compared with individuals from African population control cohorts (median GRS 1176 [interquartile range,] in islet autoantibody-positive participants versus 8.50 [7.05-9.76] in controls; P < 0.0001).Participants who were islet autoantibody negative had a markedly lower GRS for T1D than those with islet autoantibody positive status (median GRS 9.66 ; P < 0.001).Although substantially reduced in comparison with autoantibody-positive participants, the GRS for T1D in this autoantibody-negative group was higher than in a control population without diabetes (P < 0.0001).Although participants https://ispae-jped.com/