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Cited by 20Diabetes and associated disordersDiabetes Management and ResearchGenetic Associations and Epidemiology

Clinical features, biochemistry and HLA-DRB1 status in youth-onset type 1 diabetes in Pakistan

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Fawwad, Asher, Govender, Denira, Ahmedani, Mohammad Yakoob, Basit, Abdul, Lane, Julie Ann, Mack, Steven John, Atkinson, Mark Alvin, Henry Wasserfall, Clive +2 more·2019·Diabetes Research and Clinical Practice
DOI 10.1016/j.diabres.2019.01.023PMC PMC6456725
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Abstract

Published information on diabetes in Pakistani youth is limited. We aimed to investigate the demographic, clinical, and biochemical features, and HLA-DRB1 alleles in new cases of diabetes affecting children and adolescents <22 years of age. The study was conducted at Baqai Institute of Diabetology and Endocrinology in Karachi from June 2013-December 2015. One hundred subjects aged <22 years at diagnosis were enrolled. Demographic characteristics, clinical information, biochemical parameters (blood glucose, HbA1c, C-peptide, glutamic acid decarboxylase 65 (GAD65) and islet antigen 2 (IA-2) autoantibodies) were measured. DNA from 100 subjects and 200 controls was extracted and genotyped for HLA-DRB1 using high-resolution genotyping technology. Ninety-nine subjects were clinically diagnosed as type 1 diabetes (T1D) and one as type 2 diabetes (T2D). Of the 99 with T1D, 57 (57.6%) were males and 42 (42.4%) females, with mean age at diagnosis 11.0 ± 5.2 years (range 1.6-21.7 years) and peaks at six and fifteen years. Fifty-seven subjects were assessed within one month of diagnosis and all within eleven months. For the subjects diagnosed as T1D, mean C-peptide was 0.63 ± 0.51 nmol/L (1.91 ± 1.53 ng/mL), with 16 (16.2%) IA2 positive, 53 (53.5%) GAD-65 positive, and 10 (10.1%) positive for both autoantibodies. In T1D patients, the allele DRB1*03:01 demonstrated highly significant T1D association (p < 10-16), with no apparent risk conferred by DRB1*04:xx alleles. CONCLUSIONS: Heterogeneous forms of T1D appear more common in children and youth in Pakistan than in European populations. Individual understanding of such cases could enable improved management strategies and healthier outcomes.

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  • C-peptide measurements and other advanced diagnostics and phenotyping are being implemented in youth in less advantaged regions who have been newly diagnosed with diabetes mellitus.

    “However, this picture is changing with C-peptide measurements and other advanced diagnostics and phenotyping being implemented in youth in less advantaged regions who have been newly diagnosed with diabetes mellitus93–98.”

    From The epidemiology of type 1 diabetes mellitus in older adults (2025) · cites this paper as [96]

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Cited by

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Authors
Fawwad, A., Govender, D., Ahmedani, M. Y., Basit, A., Lane, J. A., Mack, S. J., Atkinson, M. A., Henry Wasserfall, C., Ogle, G. D., & Noble, J. A.
Affiliations
  • Baqai Medical University (PK)
  • The University of Sydney (AU)
  • Baqai Institute of Diabetology and Endocrinology (PK)
  • University of Florida Health (US)
Corresponding author
  • Fawwad, Asher
  • Govender, Denira
  • Ahmedani, Mohammad Yakoob
  • Basit, Abdul
  • Lane, Julie Ann
  • Mack, Steven John
  • Atkinson, Mark Alvin
  • Ogle, Graham David
  • Noble, Janelle Annette
ORCID
Venue
Diabetes Research and Clinical Practice
Publisher
Elsevier BV
Published
2019-03
Volume
149
Pages
9-17
ISSN
0168-8227 (ISSN-L)
DOI
10.1016/j.diabres.2019.01.023
PMC
PMC6456725
OpenAlex
W2913435029
Cited by
20
References
3
Citations by year
2026: 1 · 2025: 1 · 2024: 5 · 2023: 2 · 2022: 4 · 2021: 2 · 2020: 3 · 2019: 2
FWCI
1.66
Type
journal article
Language
en
Open access
Licence
Locations
  • Diabetes Research and Clinical Practice (acceptedVersion)
  • PubMed (publishedVersion)
  • Europe PMC (PubMed Central) (acceptedVersion)
  • PubMed Central (acceptedVersion)
  • eScholarship (California Digital Library) (submittedVersion)
Funders
  • Leona M. and Harry B. Helmsley Charitable Trust
  • National Institutes of Health
  • NIAID (R01AI28775)
  • NIH
Topics
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Diabetes and associated disorders
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Genetic Associations and Epidemiology
Keywords
type 1 diabetes, youth-onset diabetes, HLA-DRB1, HLA-DRB1*0301, autoantibodies, GAD65, IA-2, C-peptide, HbA1c, children and adolescents, Pakistan, genetic susceptibility
MeSH terms
Adolescent, Adult, Autoantibodies, C-Peptide, Child, Child, Preschool, Diabetes Mellitus, Type 1, Female, Humans, Infant, Male, Pakistan, Young Adult, HLA-DRB1 Chains

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