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Cited by 16Diabetes and associated disordersDiabetes Management and ResearchGenetic Associations and Epidemiology

Clinical features, biochemistry, and HLA‐DRB1 status in youth‐onset type 1 diabetes in Sudan

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Ibrahim, Tomader Ali Mohammed, Govender, Denira, Abdullah, Mohamed Ahmed, Noble, Janelle Annette, Hussien, Mohammed Osman, Lane, Julie Ann, Mack, Steven John, Martin, Gregory George Noble +3 more·2021·Pediatric Diabetes
DOI 10.1111/pedi.13209PMC PMC8274711
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Abstract

Objective To further understand clinical and biochemical features, and HLA-DRB1 genotypes, in new cases of diabetes in Sudanese children and adolescents. Research Design and Methods Demographic characteristics, clinical information, and biochemical parameters (blood glucose, HbA1c, C-peptide, autoantibodies against glutamic acid decarboxylase 65 [GADA] and insulinoma-associated protein-2 [IA-2A], and HLA-DRB1) were assessed in 99 individuals <18 years, recently (<18 months) clinically diagnosed with T1D. HLA-DRB1 genotypes for 56 of these Arab individuals with T1D were compared to a mixed control group of 198 healthy Arab (75%) and African (25%) individuals without T1D. Results Mean ± SD age at diagnosis was 10.1 ± 4.3 years (range 0.7–17.6 years) with mode at 9–12 years. A female preponderance was observed. Fifty-two individuals (55.3%) presented in diabetic ketoacidosis (DKA). Mean ± SD serum fasting C-peptide values were 0.22 ± 0.25 nmol/L (0.66±0.74 ng/ml). 31.3% were autoantibody negative, 53.4% were GADA positive, 27.2% were IA-2A positive, with 12.1% positive for both autoantibodies. Association analysis compared to 198 controls of similar ethnic origin revealed strong locus association with HLA-DRB1 (p < 2.4 × 10–14). Five HLA-DRB1 alleles exhibited significant T1D association: three alleles (DRB1*03:01, DRB1*04:02, and DRB1*04:05) were positively associated, while three (DRB1*10:01, DRB1*15:02, and DRB1*15:03) were protective. DRB1*03:01 had the strongest association (odds ratio = 5.04, p = 1.7 × 10–10). Conclusions Young Sudanese individuals with T1D generally have similar characteristics to reported European-origin T1D populations. However, they have higher rates of DKA and slightly lower autoantibody rates than reported European-origin populations, and a particularly strong association with HLA-DRB1*03:01.

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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 [94]

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Authors
Ibrahim, T. A. M., Govender, D., Abdullah, M. A., Noble, J. A., Hussien, M. O., Lane, J. A., Mack, S. J., Martin, G. G. N., Atkinson, M. A., Wasserfall, C. H., & Ogle, G. D.
Affiliations
  • Sudanese Children's Diabetes Association Khartoum Sudan
  • The University of Sydney (AU)
  • University of Khartoum (SD)
  • University of California, San Francisco (US)
  • Ministry of Higher Education And Scientific Research (SD)
  • Children's Hospital Oakland Research Institute Oakland California USA
  • University of Florida Health (US)
Corresponding author
Ogle, Graham David
ORCID
Venue
Pediatric Diabetes
Publisher
Wiley
Published
2021-04-20
Volume
22
Issue
5
Pages
749-757
ISSN
  • 1399-543X (ISSN-L)
  • 1399-5448
DOI
10.1111/pedi.13209
PMC
PMC8274711
OpenAlex
W3139790247
Cited by
16
References
2
Citations by year
2026: 1 · 2025: 1 · 2024: 7 · 2023: 5 · 2022: 2
FWCI
1.98
Type
journal article
Language
en
Open access
Licence
Locations
  • Pediatric Diabetes (publishedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
  • eScholarship (California Digital Library) (submittedVersion)
Funders
  • Leona M. and Harry B. Helmsley Charitable Trust (2019PG‐T1D023)
  • National Institutes of Health (R01AI28775)
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, genetic association, GADA, IA-2A, C-peptide, diabetic ketoacidosis, HLA-DRB1*0301, autoantibodies, age at diagnosis, HbA1c, Arabs, genetic susceptibility
MeSH terms
Adolescent, Autoantibodies, C-Peptide, Child, Child, Preschool, Diabetes Mellitus, Type 1, Female, Genotype, Glutamate Decarboxylase, Humans, Infant, Male, Sudan, Biomarkers, Case-Control Studies, Diabetic Ketoacidosis, Age of Onset, Genetic Predisposition to Disease, HLA-DRB1 Chains

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