The number of children who develop type 1 diabetes is increasing worldwide and they are eight and a half years old on average when diagnosed. Already at this age many children show severe functional deterioration, but successful prevention strategies and detailed screening can help prevent this.
Researchers have developed a new approach to improve and extend risk type 1 diabetes screening. “Acute severe complications such as diabetic coma at disease onset can thus be avoided in the majority of the children,” explained study author Dr. Peter Achenbach. The scientists evaluated the data of 1,633 children who had at least one type 1 diabetes parent. These children’s risk for diabetes was elevated in comparison with children who had no family history of diabetes.
Image: Computer rendered image of human insulin molecule.
Genetic factors play a significant role in the development of type 1 diabetes. The scientists were able to show that specific variants of the zinc transporter gene SLC30A8 influence the risk for diabetes. The body needs this gene in order to produce ZnT8. This protein influences the zinc transport into the beta cells and plays a crucial role in their maturation and thus also in insulin secretion.
Beta cells of the islets of Langerhans in the pancreas secrete the vitally important insulin. Already prior to the onset of type 1 diabetes the body’s own immune system destroys the beta cells. If this destruction exceeds a certain threshold, the disease becomes manifest: The insulin deficiency leads to various metabolic disturbances, including elevated blood glucose levels.
“Autoantibodies to ZnT8 in combination with a specific variant of the zinc transporter gene were associated with an elevated diabetes risk,” said Dr. Peter Achenbach of the Institute for Diabetes Research. “Eighty-one percent of these children with ZnT8 antibodies developed diabetes mellitus.” A heightened diabetes risk has long been associated with the islet autoantibodies. These include the autoantibodies to insulin (IAA), islet cell antibodies to the enzyme glutamate decarboxylase (GADA) and to tyrosine phosphatases (IA-2A and IA-2ß).
Autoantibodies to ZnT8 are an additional important marker for the progression of diabetes, especially in children who are already developing islet autoantibodies. A differentiated analysis of all autoantibodies allows the prognosis of how fast the disease will become manifest. The rule of thumb is: The larger the number of different kinds of autoantibodies, the higher the risk for diabetes, and the younger the child with autoantibodies, the earlier disease onset will be. These high-risk individuals require especially careful monitoring.
References:
1. P. Achenbach, V. Lampasona, U. Landherr, K. Koczwara, S. Krause, H. Grallert, C. Winkler, M. Pflüger, T. Illig, E. Bonifacio, A. G. Ziegler: Autoantibodies to zinc transporter 8 and SLC30A8 genotype stratify type 1 diabetes risk, Diabetologia: Diabetologia. 2009.
