Use of the diabetes prevention trial-type 1 risk score (DPTRS) for improving the accuracy of the risk classification of type 1 diabetes

Jay M. Sosenko, Jay S. Skyler, Jeffrey Mahon, Jeffrey P. Krische, Carla J. Greenbaum, Lisa E. Rafkin, Craig A. Beam, David C. Boulware, Della Matheson, David Cuthbertson, Kevan C. Herold, George Eisenbarth, Jerry P. Palmer

Research output: Contribution to journalArticle

16 Scopus citations

Abstract

OBJECTIVE: We studied the utility of the Diabetes Prevention Trial-Type 1 Risk Score (DPTRS) for improving the accuracy of type 1 diabetes (T1D) risk classification in TrialNet Natural History Study (TNNHS) participants. RESEARCH DESIGN AND METHODS: The cumulative incidence of T1D was compared between normoglycemic individuals with DPTRS values >7.00 and dysglycemic individuals in the TNNHS (n = 991). It was also compared between individuals with DPTRS values <7.00 or >7.00 among those with dysglycemia and those with multiple autoantibodies in the TNNHS. DPTRS values >7.00 were compared with dysglycemia for characterizing risk in Diabetes Prevention Trial-Type 1 (DPT-1) (n = 670) and TNNHS participants. The reliability of DPTRS values >7.00 was compared with dysglycemia in the TNNHS. RESULTS: The cumulative incidence of T1D for normoglycemic TNNHS participants with DPTRS values >7.00 was comparable to those with dysglycemia. Among those with dysglycemia, the cumulative incidence was much higher ( P < 0.001) for those with DPTRS values >7.00 than for those with values <7.00 (3-year risks: 0.16 for <7.00 and 0.46 for >7.00). Dysglycemic individuals in DPT-1 were at much higher risk for T1D than those with dysglycemia in the TNNHS (P < 0.001); there was no significant difference in risk between the studies among those with DPTRS values >7.00. The proportion in the TNNHS reverting from dysglycemia to normoglycemia at the next visit was higher than the proportion reverting from DPTRS values >7.00 to values <7.00 (36 vs. 23%). CONCLUSIONS: DPTRS thresholds can improve T1D risk classification accuracy by identifying high-risk normoglycemic and low-risk dysglycemic individuals. The 7.00 DPTRS threshold characterizes risk more consistently between populations and has greater reliability than dysglycemia.

Original languageEnglish (US)
Pages (from-to)979-984
Number of pages6
JournalDiabetes care
Volume37
Issue number4
DOIs
StatePublished - Apr 2014

ASJC Scopus subject areas

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism
  • Advanced and Specialized Nursing

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    Sosenko, J. M., Skyler, J. S., Mahon, J., Krische, J. P., Greenbaum, C. J., Rafkin, L. E., Beam, C. A., Boulware, D. C., Matheson, D., Cuthbertson, D., Herold, K. C., Eisenbarth, G., & Palmer, J. P. (2014). Use of the diabetes prevention trial-type 1 risk score (DPTRS) for improving the accuracy of the risk classification of type 1 diabetes. Diabetes care, 37(4), 979-984. https://doi.org/10.2337/dc13-2359