Abstract
Aims
To evaluate access to screening tools for monogenic diabetes in paediatric diabetes
centres across the world and its impact on diagnosis and clinical outcomes of children
and youth with genetic forms of diabetes.
Methods
79 centres from the SWEET diabetes registry including 53,207 children with diabetes
participated in a survey on accessibility and use of diabetes related antibodies,
c-peptide and genetic testing.
Results
73, 63 and 62 participating centres had access to c-peptide, antibody and genetic
testing, respectively. Access to antibody testing was associated with higher proportion
of patients with rare forms of diabetes identified with monogenic diabetes (54 % versus
17 %, p = 0.01), lower average whole clinic HbA1c (7.7[Q1,Q2: 7.3–8.0]%/61[56–64]mmol/mol
versus 9.2[8.6–10.0]%/77[70–86]mmol/mol, p < 0.001) and younger age at onset (8.3
[7.3–8.8] versus 9.7 [8.6–12.7] years p < 0.001). Additional access to c-peptide or
genetic testing was not related to differences in age at onset or HbA1c outcome.
Conclusions
Clinical suspicion and antibody testing are related to identification of different
types of diabetes. Implementing access to comprehensive antibody screening may provide
important information for selecting individuals for further genetic evaluation. In
addition, worse overall clinical outcomes in centers with limited diagnostic capabilities
indicate they may also need support for individualized diabetes management.
Trial Registration: NCT04427189.
Keywords
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Article info
Publication history
Published online: September 29, 2022
Accepted:
September 25,
2022
Received in revised form:
September 19,
2022
Received:
August 19,
2022
Identification
Copyright
© 2022 Published by Elsevier B.V.
