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Cited by 10Diabetes and associated disordersDiabetes Management and ResearchGenetic Associations and Epidemiology

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

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Besançon, Stéphane, Govender, Denira, Sidibé, Assa Traore, Noble, Janelle Annette, Togo, Amagara, Lane, Julie Ann, Mack, Steven John, Atkinson, Mark A. +4 more·2022·Pediatric Diabetes
DOI 10.1111/pedi.13411PMC PMC9771900
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Abstract

OBJECTIVE: Limited information is available regarding youth-onset diabetes in Mali. We investigated demographic, clinical, biochemical, and genetic features in new diabetes cases in children and adolescents. RESEARCH DESIGN AND METHODS: The study was conducted at Hôpital du Mali in Bamako. A total of 132 recently-diagnosed cases <21 years were enrolled. Demographic characteristics, clinical information, biochemical parameters (blood glucose, HbA1c, C-peptide, glutamic acid decarboxylase-65 (GAD-65) and islet antigen-2 (IA2) autoantibodies) were assessed. DNA was genotyped for HLA-DRB1 using high-resolution genotyping technology. RESULTS: A total of 130 cases were clinically diagnosed as type 1 diabetes (T1D), one with type 2 diabetes (T2D), and one with secondary diabetes. A total of 66 (50.8%) T1D cases were males and 64 (49.2%) females, with a mean age at diagnosis of 13.8 ± 4.4 years (range 0.8-20.7 years) peak onset of 15 years. 58 (44.6%) presented in diabetic ketoacidosis; with 28 (21.5%) IA2 positive, 76 (58.5%) GAD-65 positive, and 15 (11.5%) positive for both autoantibodies. HLA was also genotyped in 195 controls without diabetes. HLA-DRB1 genotyping of controls and 98 T1D cases revealed that DRB1*03:01, DRB1*04:05, and DRB1*09:01 alleles were predisposing for T1D (odds ratios [ORs]: 2.82, 14.76, and 3.48, p-values: 9.68E-5, 2.26E-10, and 8.36E-4, respectively), while DRB1*15:03 was protective (OR = 0.27; p-value = 1.73E-3). No significant differences were observed between T1D cases with and without GAD-65 and IA2 autoantibodies. Interestingly, mean C-peptide was 3.6 ± 2.7 ng/ml (1.2 ± 0.9 nmol/L) in T1D cases at diagnosis. CONCLUSIONS: C-peptide values were higher than expected in those diagnosed as T1D and autoantibody rates lower than in European populations. It is quite possible that some cases have an atypical form of T1D, ketosis-prone T2D, or youth-onset T2D. This study will help guide assessment and individual management of Malian diabetes cases, potentially enabling 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 [95]

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Authors
Besançon, S., Govender, D., Sidibé, A. T., Noble, J. A., Togo, A., Lane, J. A., Mack, S. J., Atkinson, M. A., Wasserfall, C. H., Kakkat, F., Martin, G. G. N., & Ogle, G. D.
Affiliations
  • ONG Santé Diabète Bamako Mali
  • The University of Sydney (AU)
  • Hôpital du Mali (ML)
  • University of California, San Francisco (US)
  • Children's Hospital Oakland Research Institute Oakland California USA
  • University of Florida Health (US)
  • Life for a Child Program Diabetes NSW &amp; ACT Glebe New South Wales Australia
Corresponding author
Ogle, Graham David
ORCID
Venue
Pediatric Diabetes
Publisher
Wiley
Published
2022-09-10
Volume
23
Issue
8
Pages
1552-1559
ISSN
  • 1399-543X (ISSN-L)
  • 1399-5448
DOI
10.1111/pedi.13411
PMC
PMC9771900
OpenAlex
W4294597728
Cited by
10
References
1
Citations by year
2026: 1 · 2025: 3 · 2024: 2 · 2023: 4
FWCI
1.36
Type
journal article
Language
en
Open access
Licence
Locations
  • Pediatric Diabetes (publishedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
  • eScholarship (California Digital Library) (submittedVersion, cc-by)
Funders
  • Leona M. and Harry B. Helmsley Charitable Trust
  • National Institutes of Health
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 susceptibility, IA-2 autoantibodies, C-peptide, HbA1c, diabetic ketoacidosis, type 2 diabetes, adolescents, Mali
MeSH terms
Adolescent, Adult, Autoantibodies, C-Peptide, Child, Child, Preschool, Diabetes Mellitus, Type 1, Diabetes Mellitus, Type 2, Female, Glutamate Decarboxylase, Humans, Infant, Male, Mali, Genetic Predisposition to Disease, Young Adult, HLA-DRB1 Chains

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