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Cited by 28Diabetes and associated disordersDiabetes Management and ResearchPancreatic function and diabetes

Clinical features, biochemistry and HLA-DRB1 status in children and adolescents with diabetes in Dhaka, Bangladesh

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Zabeen, Bedowra, Govender, Denira, Hassan, Zahid, Noble, Janelle Annette, Lane, Julie A., Mack, Steven John, Atkinson, Mark Alvin, Azad, Kishwar +2 more·2019·Diabetes Research and Clinical Practice
DOI 10.1016/j.diabres.2019.107894PMC PMC6988504
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Abstract

Aims Little information is published on diabetes in young people in Bangladesh. We aimed to investigate the demographic, clinical, and biochemical features, and HLA-DRB1 alleles in new cases of diabetes affecting Bangladeshi children and adolescents <22 years of age. Methods The study was conducted at Bangladesh Institute of Research and Rehabilitation of Diabetes, Endocrine and Metabolic Disorders (BIRDEM) in Dhaka. One hundred subjects aged <22 years at diagnosis were enrolled. Demographic characteristics, clinical information, biochemical parameters (blood glucose, HbA1c, C-peptide, and autoantibodies against glutamic acid decarboxylase 65 (GADA) and islet antigen-2 (IA-2A) were measured. High-resolution DNA genotyping was performed for HLA-DRB1. Results Eighty-four subjects were clinically diagnosed as type 1 diabetes (T1D), seven as type 2 diabetes (T2D), and nine as fibrocalculous pancreatic disease (FCPD). Of the 84 with T1D, 37 (44%) were males and 47 (56%) females, with median age at diagnosis 13 years (y) (range 1.6-21.7) and peak age at onset 12-15 years. 85% of subjects were assessed within one month of diagnosis and all within eleven months. For subjects diagnosed with T1D, mean C-peptide was 0.46 ± 0.22 nmol/L (1.40 ± 0.59 ng/mL), with 9 (10.7%) IA-2A positive, 22 (26%) GADA positive, and 5 (6%) positive for both autoantibodies. Analysis of HLA-DRB1 genotypes revealed locus-level T1D association (p = 6.0E-05); DRB1*04:01 appeared predisposing (p < 3.0E-06), and DRB1*14:01 appeared protective (p = 1.7E-02). Conclusions Atypical forms of T1D appear to be more common in young people in Bangladesh than in European populations. This will be helpful in guiding more specific assessment at onset and potentially, expanding treatment options.

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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 [97]

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Authors
Zabeen, B., Govender, D., Hassan, Z., Noble, J. A., Lane, J. A., Mack, S. J., Atkinson, M. A., Azad, K., Wasserfall, C. H., & Ogle, G. D.
Affiliations
  • Bangladesh Institute of Research and Rehabilitation for Diabetes Endocrine and Metabolic Disorders (BD)
  • The University of Sydney (AU)
  • Bangladesh University of Health Sciences (BD)
  • University of Florida Health (US)
  • University of Florida (US)
Corresponding author
  • Govender, Denira
  • Hassan, Zahid
  • Noble, Janelle Annette
  • Lane, Julie A.
  • Mack, Steven John
  • Atkinson, Mark Alvin
  • Azad, Kishwar
  • Wasserfall, Clive Henry
  • Ogle, Graham David
ORCID
Venue
Diabetes Research and Clinical Practice
Publisher
Elsevier BV
Published
2019-12
Volume
158
Pages
107894
ISSN
0168-8227 (ISSN-L)
DOI
10.1016/j.diabres.2019.107894
PMC
PMC6988504
OpenAlex
W2981837178
Cited by
28
References
3
Citations by year
2026: 3 · 2025: 2 · 2024: 7 · 2023: 4 · 2022: 6 · 2021: 3 · 2020: 3
FWCI
1.81
Type
journal article
Language
en
Open access
Licence
Locations
  • Diabetes Research and Clinical Practice (publishedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
  • eScholarship (California Digital Library) (submittedVersion)
Funders
Leona M. and Harry B. Helmsley Charitable Trust
Topics
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Diabetes and associated disorders
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
  • Health Sciences › Medicine › Surgery › Pancreatic function and diabetes
Keywords
type 1 diabetes, type 2 diabetes, HLA-DRB1, HLA-DRB1*0401, autoantibodies, GADA, IA-2A, C-peptide, HbA1c, children and adolescents, Bangladesh, age of onset, genetic susceptibility
MeSH terms
Adolescent, Adult, Bangladesh, C-Peptide, Child, Child, Preschool, Diabetes Mellitus, Type 2, Female, Humans, Infant, Male, Young Adult, HLA-DRB1 Chains

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