Positive islet autoantibodies confirm classical type 1 diabetes in patients treated as type 2 diabetes who have early progression to insulin

Adults initially managed as type 2 diabetes who progress to insulin within 3 years and are islet-autoantibody positive show classical type 1 diabetes genetics and C-peptide loss.

• Why it matters: Guidelines recommend islet-autoantibody testing for adults who need insulin within 3 years, but direct evidence linking positive results to classical type 1 diabetes progression was lacking.
• What they did: In 86 islet-autoantibody-positive adults progressing to insulin within 3 years, investigators compared T1DGRS/T2DGRS and prospectively measured annual urine C-peptide creatinine ratio change over 3 years versus classical type 1 (n=499) and type 2 (n=603) diabetes.
• The result: Genetic scores and C-peptide decline were similar to classical type 1 diabetes (T1DGRS p=0.71; urine C-peptide creatinine ratio −47% vs −49%, p=0.6), supporting diagnosis and treatment as type 1 diabetes.

AI summary of the abstract · may contain errors · not medical advice · read the paper.