Brief communication: early appearance of islet autoantibodies predicts childhood type 1 diabetes in offspring of diabetic parents

Ann Intern Med. 2004 Jun 1;140(11):882-6. doi: 10.7326/0003-4819-140-11-200406010-00009.


Background: The development of type 1 diabetes mellitus is preceded by autoimmunity against islet beta cells.

Objective: To determine the risk for islet autoimmunity and childhood diabetes in offspring of affected parents.

Design: Prospective cohort study.

Setting: German BABYDIAB study.

Participants: 1610 offspring of parents with type 1 diabetes.

Measurements: Autoantibodies to islet autoantigens were measured at 9 months, 2 years, 5 years, and 8 years of age.

Results: By 5 years of age, the frequency of islet autoantibodies was 5.9% (95% CI, 4.6% to 7.2%), the frequency of multiple islet autoantibodies was 3.5% (CI, 2.5% to 4.5%), and the frequency of diabetes was 1.5% (CI, 0.9% to 2.1%). The risk for diabetes was highest in offspring with multiple autoantibodies (40% within 5 years vs. 3% in offspring with single autoantibodies; P = 0.005). Progression to multiple islet autoantibodies was fastest in children who were autoantibody positive by age 2 years (P < 0.001), and progression to diabetes was inversely related to the age of positivity for multiple autoantibodies (P = 0.02).

Limitations: The findings are limited to childhood diabetes in affected families.

Conclusions: Childhood autoimmune diabetes is associated with autoimmunity that starts before 2 years of age.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Autoantibodies / blood*
  • Child
  • Child, Preschool
  • Diabetes Mellitus, Type 1 / genetics*
  • Diabetes Mellitus, Type 1 / immunology*
  • Female
  • Genetic Predisposition to Disease*
  • Humans
  • Infant
  • Infant, Newborn
  • Islets of Langerhans / immunology*
  • Male
  • Prospective Studies
  • Risk Factors


  • Autoantibodies