Diabetes autoantibodies do not predict progression to diabetes in adults: the Diabetes Prevention Program

Abstract

Aims: To determine if the presence of diabetes autoantibodies predicts the development of diabetes among participants in the Diabetes Prevention Program.

Methods: A total of 3050 participants were randomized into three treatment groups: intensive lifestyle intervention, metformin and placebo. Glutamic acid decarboxylase (GAD) 65 autoantibodies and insulinoma-associated-2 autoantibodies were measured at baseline and participants were followed for 3.2 years for the development of diabetes.

Results: The overall prevalence of GAD autoantibodies was 4.0%, and it varied across racial/ethnic groups from 2.4% among Asian-Pacific Islanders to 7.0% among non-Hispanic black people. There were no significant differences in BMI or metabolic variables (glucose, insulin, HbA(1c), estimated insulin resistance, corrected insulin response) stratified by baseline GAD antibody status. GAD autoantibody positivity did not predict diabetes overall (adjusted hazard ratio 0.98; 95% CI 0.56-1.73) or in any of the three treatment groups. Insulinoma-associated-2 autoantibodies were positive in only one participant (0.033%).

Conclusions: These data suggest that 'diabetes autoimmunity', as reflected by GAD antibodies and insulinoma-associated-2 autoantibodies, in middle-aged individuals at risk for diabetes is not a clinically relevant risk factor for progression to diabetes.

Trial registration: ClinicalTrials.gov NCT00038727.

Conflict of interest statement

Competing interests

None declared.

© 2014 The Authors. Diabetic Medicine © 2014 Diabetes UK.

Figures

FIGURE 1

Incidence of diabetes over 3.2 years (per 100 person-years with 95% CIs), by treatment group and glutamic acid decarboxylase (GAD) status at baseline in the Diabetes Prevention Program.