A population-based cohort study provides new data on the prevalence of early-stage type 1 diabetes in young adults, addressing a gap in epidemiological research. Using samples from the LISA and GINIplus cohorts and methodologies established in the Fr1da study, researchers from the Institute of Diabetes Research and the Institute of Epidemiology at Helmholtz Munich demonstrate the potential of extending early detection strategies into adulthood. The findings are presented in a new Correspondence published in The Lancet Diabetes & Endocrinology.
Investigating Presymptomatic Type 1 Diabetes Beyond Childhood
Type 1 diabetes is a chronic autoimmune disease characterized by the immune-mediated destruction of insulin-producing beta cells. Although traditionally regarded as a childhood-onset condition, it is now increasingly recognized that type 1 diabetes can also manifest during adolescence and adulthood. Helmholtz Munich researchers have investigated the prevalence of early-stage type 1 diabetes in young adults, addressing an underexplored phase of the disease. The study was conducted through close collaboration between the Institute of Epidemiology (EPI) and the Institute of Diabetes Research (IDF), combining expertise in population-based epidemiology and the pathophysiology of diabetes.
The analysis included 1,377 participants from the long-running LISA and GINIplus birth cohorts, which follow individuals prospectively from birth into young adulthood, with assessments conducted up to 25 years of age. Blood samples were screened for islet autoantibodies using the methodology established in the Fr1da Study, including confirmatory testing to ensure high analytical specificity.
Islet Autoantibodies Can Develop During Adolescence and Early Adulthood
The results show that approximately 1.2 percent of previously undiagnosed young adults tested positive for islet autoantibodies, including 0.2 percent of participants who met the criteria for early-stage type 1 diabetes – prevalence rates comparable to those observed in children – and an additional 1.0 percent who had a single autoantibody. Longitudinal analyses indicated that, while the majority of the autoantibody-positive individuals had these markers by age 15 years, new development of islet autoantibodies occurred after this age. This underscores that early immunological signs of type 1 diabetes can emerge during adolescence and young adulthood.
The findings provide new evidence that early-stage type 1 diabetes occurs in the general adult population, highlighting the potential value of extending screening strategies currently focusing on children to include young adults, particularly in those who have not been previously tested in adolescence.
DZKJ PIs involved:
Dr. Marie Standl
Prof. Dr. Anette-Gabriele Ziegler
