What causes diabetes in young children?

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Diabetes affects more than 400 million people worldwide—90 per cent of whom have developed type 2 diabetes—and the number is expected to surpass 600 million by 2040.

Diabetes mellitus, often simply diabetes, is a syndrome characterized by disordered metabolism and inappropriately high blood sugar (hyperglycemia) resulting from either low levels of the hormone insulin or from abnormal resistance to insulin's effects coupled with inadequate levels of insulin secretion to compensate.

The World Health Organization recognizes three main forms of diabetes mellitus: type 1, type 2, and gestational diabetes (occurring during pregnancy), which have similar signs, symptoms, and consequences, but different causes and population distributions.

According to the TEDDY study, Levels of insulin autoantibodies (IAAs) and insulinoma-associated protein 2 autoantibodies (IA-2As) predict the onset of diabetes in young children with islet autoimmunity.

Most children who progressed to diabetes within 5 years of first islet autoantibody detection had at least two islet autoantibodies, were very young and had first-degree relatives with diabetes.

The results of the study support the notion that diabetes is likely to develop in most children with persistent multiple islet autoantibodies.

However, the time of progression to diabetes can be highly variable. Therefore, factors that can predict the age at development of diabetes may have an important prognostic value for parents and providers, and may also be of use in interim analyses of prevention trials.

Children who progressed to diabetes were significantly younger at first autoantibody detection than those who did not, at 1.3 versus 2.5 years of age, and were 1.6-fold more likely to have first-degree relatives with diabetes than those who did not progress.

After accounting for these factors, each 1-unit increase in log mean IAA level was associated with an 8.1-fold increased risk of developing diabetes during follow-up, and each 1-unit increase in log mean IA-2A level increased it 7.4-fold.

Glutamate decarboxylase 65 autoantibody levels did not influence diabetes risk, however, and neither did human leukocyte antigen genotype.

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