285-OR

Ethnic Differences in Progression to Type 1 Diabetes in Relatives at Risk

Mustafa Tosur, MDTexas Children’s Hospital & Baylor College of Medicine

Susan Geyer1, Henry Rodriguez1; Ingrid Libman2; David Baidal3; Maria J. Redondo4; and the Type 1 Diabetes TrialNet Study Group

1University of South Florida, Tampa, FL; 2University of Pittsburgh, Pittsburgh, PA;3University of Miami, Miami, FL; 4Baylor College of Medicine, Houston, TX

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PAGE TITLEDisclosures

• No conflict of interest to report

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PAGE TITLEPurpose/Objective(s)

• While a wealth of information is available on type 1 diabetes (T1D) risk factors and progression, the influence of race and ethnicity is largely unknown

• We hypothesized that race and ethnicity contribute to the heterogeneity of T1D

• We aimed to compare the progression of diabetes autoantibodies from single to multiple positivity and T1D development among races/ethnicities in at-risk individuals

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PAGE TITLEMethods/Materials• We studied 4,227 TrialNet Pathway to Prevention

participants (non-diabetic, autoantibody [Ab] positive relatives of patients with T1D)

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n=1788 (42%)n= 2439

(58%)

0%

Multiple Ab +

Single Ab +

Median Follow-up1.8 years 2.5 years

79%

12%

3% 2% 4%Non-Hispanic White (NHW)[79%]

Hispanic [12%]

Non-Hispanic Black [3%]

Non-Hispanic Asian/PacificIslander [2%]

Non-Hispanic Others [4%]

PAGE TITLEResults

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Covariate Hazard RatioNHWs 1.00Hispanics 0.59

• Progression from single to multiple Ab+: Slower in Hispanics than NHWs

PAGE TITLE

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T1D risk:• Increased by 34% in NHW• Quadrupled in Hispanics

Results, cont.• Progression from multiple Ab+ to T1D: Among children

<12 y/o, Hispanics are disproportionally affected by elevated BMI

Covariate Hazard Ratio

NHWs – lean 1.00

NHWs –overweight/obese

1.34

Hispanic – lean 0.50

Hispanic –overweight/obese

2.03

PAGE TITLEConclusions • Hispanics, compared with NHW, had lower risk of

progression from single to multiple Ab+ and, amongst lean individuals <12 years old, from multiple Ab+ to T1D

• In children <12 years old, overweight/obesity is more detrimental to Hispanics than NHWs for T1D progression

• The effect of race/ethnicity on T1D progression should be considered when counseling family members at risk and for the design of predictive models and prevention trials

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