Presentation and phases of diabetes

Prediabetes

Immunological markers

• Islet cell autoantibodies (ICA) at a high titer (>20 JDF units) predict a 40–60% risk of type 1 diabetes over the next 5–7 years

• When multiple autoantibodies are present the risk prediction rate increases greatly, e.g. glutamic acid decarboxylase (65 kD GAD isoform) plus IA2 antibodies predict a risk of >70% over 5 years. Insulin autoantibodies (IAA) at high titer may also increase the risk prediction

Genetic markers

• Certain HLA markers, particularly when identical to those of a family member with diabetes, indicate increased risk

Examples of genetic markers conferring increased risk

Examples of genetic markers conferring decreased risk