ESPE Abstracts

Background/Aim: Type 1 diabetes Mellitus (T1DM) often presents with clear clinical signs after a long-term asymptomatic autoimmune process. This long and silent period has been leading to an increase in awareness day by day in order to prevent and predict the development of the disease. Among the well-known genetic and environmental risk factors, close relatives of the index cases constitute a population that is quite suitable for predicting and preventing the development of T1DM. There is an increased risk of T1DM for first-degree relatives of patients that endure into the advanced years. This study focused on the clinical characteristics, serological and biochemical predictive markers that reflect the potential risk for T1DM in the asymptomatic siblings of index patients with newly diagnosed T1DM

Materials and Methods: A total of 112 siblings of 82 index cases were included in the study. The siblings consisted of 69 healthy asymptomatic and 43 T1DM children. The following serological and biochemical markers were screened: Islet cell antibodies containing HbA1C, C-peptide, anti-glutamic acid decarboxylase (anti-GAD), anti-insulin (anti-IA), and islet cell antibodies (anti-ICA). Participants were classified into three groups according to the age group screened: 0-4, 5-10, and ≥11 years. Three groups were evaluated in terms of clinical serological and biochemical markers. The following criteria were considered as risk factors: At least one antibody positivity, C-peptide <0.4 µg/l and HbA1C> 5.7

Results: The seropositivity rates for anti-GAD, anti-ICA and anti-IA in patients with T1DM (index cases plus siblings of index cases) were 58%, 37.3%, and 33.33%, respectively. At least one autoantibody for islet cell antibodies was positive in 5 (7.2%) of the asymptomatic siblings, while HbA1C levels were found above 5.7 in 14 (20.2%) of them. C-peptide level was not low in any of the asymptomatic siblings

Conclusion: This study showed that siblings of index cases had high rates of islet cell antibody positivity and high HbA1C levels, indicating the need for long-term close follow-up in terms of predicting, preventing, and even evaluating potential therapeutic options in siblings of index cases with T1DM.