Evaluation of Disease Complications Among Adults With Type 1 Diabetes and a Family History of Type 2 Diabetes in Taiwan

Lin, Chia-Hung; Lo, Fu‐Sung; Huang, Yu‐Yao; Sun, Jui-Hung; Chen, Szu-Tah; Kuo, Chang‐Fu; Hsieh, Mei-Yun; Hsieh, Sheng-Hwu

doi:10.1001/jamanetworkopen.2021.38775

Cited by 7 publications

(7 citation statements)

References 20 publications

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“…When it came to T2D, higher BMI and worse lipid profile were associated with family history of T2D. As consistent with previous studies on autoimmune T1D, patients with a family history of T2D had an older onset age, 15,17,18 a higher BMI, 15,16,18 and an increased risk of diabetic complications 18‐20 …”

Section: Discussionsupporting

confidence: 86%

“…As consistent with previous studies on autoimmune T1D, patients with a family history of T2D had an older onset age, 15,17,18 a higher BMI, 15,16,18 and an increased risk of diabetic complications. [18][19][20] Several studies have been conducted to investigate the potential mechanisms underlying the aforementioned implications of family history of T2D. Reduced metabolic rate, 50,51 increased ectopic lipid deposition after fructose overconsumption, 48 and higher weight and fat gain induced by experimental overfeeding 46 were found in healthy individuals with a family history of T2D, indicating that they are more susceptible to metabolic decompensation and insulin resistance.…”

Section: Discussionmentioning

confidence: 99%

“…A few studies have found that family history of T2D was associated with a metabolic profile related to insulin resistance and a greater risk of diabetic complications in T1D patients. [15][16][17][18] However, the majority of studies did not test autoantibodies for diagnosis, 16,17,19,20 and the rest included patients with autoimmune T1D as the majority (76%-97.6%) of their study populations. 15,18,21 The impact of family history of T2D on idiopathic T1D is completely unknown.…”

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confidence: 99%

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The impact of family history of type 2 diabetes on clinical heterogeneity in idiopathic type 1 diabetes

Chen

Wang

Xie

et al. 2022

Diabetes Obesity Metabolism

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Aim: To investigate the impact of family history of type 2 diabetes (T2D) on the clinical phenotypes of patients with idiopathic type 1 diabetes (T1D). Methods:In clinically diagnosed T1D cases, a total of 335 idopathic T1D patients were included in the study, after excluding autoimmune T1D using islet autoantibody testing and monogenic diabetes using a custom monogenic diabetes gene panel obtained from clinically diagnosed T1D cases. A semi-structured questionnaire was used to collect information on the presence of T2D in first-degree relatives. The demographic and metabolic markers of idiopathic T1D patients were analysed. Subgroup analysis was performed to investigate potential interactions between T2D family history and human leukocyte antigen (HLA) genotypes.Results: A total of 18.2% of individuals with idiopathic T1D had a T2D family history, and these individuals were more likely to have features associated with T2D, such as older age of onset, higher body mass index at diagnosis, lower insulin dosage and better beta-cell function, as indicated by higher levels of fasting C-peptide and 2-hour postprandial C-peptide (all P < 0.05). Additionally, regardless of HLA susceptible genotypes, the impact of family history of T2D was consistently observed in idiopathic T1D patients. Multivariable analyses showed that T2D family history was negatively correlated with the risk of beta-cell function failure in idiopathic T1D patients (P < 0.05).Conclusions: Family history of T2D may be implicated in the heterogeneity of idiopathic T1D patients.

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Section: Discussionsupporting

confidence: 86%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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The impact of family history of type 2 diabetes on clinical heterogeneity in idiopathic type 1 diabetes

Chen

Wang

Xie

et al. 2022

Diabetes Obesity Metabolism

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“…The prevalence of DKA and diagnosis of microalbuminuria was lowest among younger individuals with low A1c, which is the same subgroup with least frequent family history of diabetes. This finding suggests the hypothesis that having relatives with diabetes play an important role in the individual risks of developing some diabetes complications [ 44 ].…”

Section: Discussionmentioning

confidence: 91%

Clinical Characterization of Data-Driven Diabetes Clusters of Pediatric Type 2 Diabetes

et al. 2023

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Background. Pediatric Type 2 diabetes (T2D) is highly heterogeneous. Previous reports on adult-onset diabetes demonstrated the existence of diabetes clusters. Therefore, we set out to identify unique diabetes subgroups with distinct characteristics among youth with T2D using commonly available demographic, clinical, and biochemical data. Methods. We performed data-driven cluster analysis (K-prototypes clustering) to characterize diabetes subtypes in pediatrics using a dataset with 722 children and adolescents with autoantibody-negative T2D. The six variables included in our analysis were sex, race/ethnicity, age, BMI Z-score and hemoglobin A1c at the time of diagnosis, and non-HDL cholesterol within first year of diagnosis. Results. We identified five distinct clusters of pediatric T2D, with different features, treatment regimens and risk of diabetes complications: Cluster 1 was characterized by higher A1c; Cluster 2, by higher non-HDL; Cluster 3, by lower age at diagnosis and lower A1c; Cluster 4, by lower BMI and higher A1c; and Cluster 5, by lower A1c and higher age. Youth in Cluster 1 had the highest rate of diabetic ketoacidosis (DKA) ( p = 0.0001 ) and were most prescribed metformin ( p = 0.06 ). Those in Cluster 2 were most prone to polycystic ovarian syndrome ( p = 0.001 ). Younger individuals with lowest family history of diabetes were least frequently diagnosed with diabetic ketoacidosis ( p = 0.001 ) and microalbuminuria ( p = 0.06 ). Low-BMI individuals with higher A1c had the lowest prevalence of acanthosis nigricans ( p = 0.0003 ) and hypertension ( p = 0.03 ). Conclusions. Utilizing clinical measures gathered at the time of diabetes diagnosis can be used to identify subgroups of pediatric T2D with prognostic value. Consequently, this advancement contributes to the progression and wider implementation of precision medicine in diabetes management.

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“…Regarding diabetic nephropathy risk factors, our findings were consistent with Diabetes Control and Complications Trial (DCCT) cohort, which increased mean HbA1c, SBP, increased mean triglyceride level and longer diabetes duration were associated with presenting microalbuminuria 10 . According to Taiwan’s NHI medical claims (1995–2017), in type 1 diabetes patients with a family history of type 2 diabetes, the adjusted hazard ratio for nephropathy was also higher (HR 95% CI 1.44, 1.27–1.64) compared with those without a family history of type 2 DM 36 . Similarly, type 1 DM patients in this study who had a family history of diabetes had higher odds of having diabetic nephropathy (OR 95% CI 1.91, 1.34–2.72; p < 0.001).…”

Section: Discussionmentioning

confidence: 99%

Age at onset of type 1 diabetes between puberty and 30 years old is associated with increased diabetic nephropathy risk

Lin,

Sheu,

et al. 2024

Sci Rep

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Diabetic nephropathy is a critical complication of patients with type 1 diabetes, while epidemiological studies were scarce among Asian countries. We conducted a cross-sectional study to identify factors associated with diabetic nephropathy by questionnaires, using student’s t-test, chi-square test, and multivariable logistic regression. Among 898 participants, 16.7% had diabetic nephropathy. Compared with non-diabetic nephropathy patients, the patients with diabetic nephropathy had significantly higher percentage with onset age of type 1 diabetes between puberty and under 30 years old (female ≥ 12 or male ≥ 13 years old to 29 years old), longer diabetes duration, having family history of diabetes and diabetic nephropathy, accompanied with hypertension, hyperlipidemia, or coronary artery disease (CAD). Compared with patients with onset age before puberty, the odds of diabetic nephropathy occurrence increased to 1.61 times in patients with onset age between puberty and under 30 years old (p = 0.012) after adjusting diabetes duration. Age of diabetes onset between puberty and under 30 years old, diabetes duration, HbA1c, hospital admission within 3 years, diabetic retinopathy, hypertension, systolic blood pressure (SBP), triglyceride levels, and use of angiotensin converting enzyme inhibitor (ACEI) and/or angiotensin receptor blockers (ARB) were independent factors associated with diabetic nephropathy Screening for proteinuria is important in daily clinical practice and should be part of diabetes self-management education for patients with type 1 diabetes.

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Evaluation of Disease Complications Among Adults With Type 1 Diabetes and a Family History of Type 2 Diabetes in Taiwan

Cited by 7 publications

References 20 publications

The impact of family history of type 2 diabetes on clinical heterogeneity in idiopathic type 1 diabetes

The impact of family history of type 2 diabetes on clinical heterogeneity in idiopathic type 1 diabetes

Clinical Characterization of Data-Driven Diabetes Clusters of Pediatric Type 2 Diabetes

Age at onset of type 1 diabetes between puberty and 30 years old is associated with increased diabetic nephropathy risk

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