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Low risk for diabetic complications in type 1 diabetes patients carrying a protective insulin gene variant
Type 1 diabetes patients carrying a ‘protective’ insulin gene (INS) variant present a disease endotype with reduced insulin antibody titers, preserved beta cell function and improved glycemic control. We tested whether this protective INS variant associated with lowered risk for development of proli...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Public Library of Science
2023
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9879388/ https://www.ncbi.nlm.nih.gov/pubmed/36701305 http://dx.doi.org/10.1371/journal.pone.0280872 |
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author | van Tienhoven, René Vu, Anh Nguyet Kaddis, John S. Roep, Bart O. |
author_facet | van Tienhoven, René Vu, Anh Nguyet Kaddis, John S. Roep, Bart O. |
author_sort | van Tienhoven, René |
collection | PubMed |
description | Type 1 diabetes patients carrying a ‘protective’ insulin gene (INS) variant present a disease endotype with reduced insulin antibody titers, preserved beta cell function and improved glycemic control. We tested whether this protective INS variant associated with lowered risk for development of proliferative diabetic retinopathy (PDR) and diabetic kidney disease (DKD) as long-term diabetic complications. Insulin gene polymorphisms were evaluated in 1,363 type 1 diabetes patients participating in the Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications (DCCT/EDIC) study that compared intensive versus conventional insulin therapy in relation with development of PDR and DKD with a follow-up of over two decades. PDR and DKD were absent in type 1 diabetes patients carrying the protective INS variant and receiving intensive insulin therapy (the current standard of clinical care) 1–5 years from their diagnosis (n = 67; mean post-diagnosis follow up of 20.4 ± 1.6 years), versus 11 of 258 patients (4.3%) lacking this variant (20.4 ± 1.8 years follow up). In the secondary intervention group of the intensive therapy arm (1–15 years of disease), PDR was significantly less frequent in carriers of the protective INS variant than those without it (4 of 83 [4.8%] vs. 31 of 260 [11.9%]; p = 0.032; 26.1 ± 3.9 and 26.3 ± 4.1 years follow-up, respectively), whereas DKD frequencies were no different between those with or without this variant (5 of 83 [6.0%] vs. 11 of 260 [4.2%]). Carrying a copy of this protective INS variant further reduces the risk of diabetic complications achieved by intensive insulin therapy and marks a disease endotype with superior glycemic control, increased and extended beta cell function, and prevention of DKD and PDR. |
format | Online Article Text |
id | pubmed-9879388 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Public Library of Science |
record_format | MEDLINE/PubMed |
spelling | pubmed-98793882023-01-27 Low risk for diabetic complications in type 1 diabetes patients carrying a protective insulin gene variant van Tienhoven, René Vu, Anh Nguyet Kaddis, John S. Roep, Bart O. PLoS One Research Article Type 1 diabetes patients carrying a ‘protective’ insulin gene (INS) variant present a disease endotype with reduced insulin antibody titers, preserved beta cell function and improved glycemic control. We tested whether this protective INS variant associated with lowered risk for development of proliferative diabetic retinopathy (PDR) and diabetic kidney disease (DKD) as long-term diabetic complications. Insulin gene polymorphisms were evaluated in 1,363 type 1 diabetes patients participating in the Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications (DCCT/EDIC) study that compared intensive versus conventional insulin therapy in relation with development of PDR and DKD with a follow-up of over two decades. PDR and DKD were absent in type 1 diabetes patients carrying the protective INS variant and receiving intensive insulin therapy (the current standard of clinical care) 1–5 years from their diagnosis (n = 67; mean post-diagnosis follow up of 20.4 ± 1.6 years), versus 11 of 258 patients (4.3%) lacking this variant (20.4 ± 1.8 years follow up). In the secondary intervention group of the intensive therapy arm (1–15 years of disease), PDR was significantly less frequent in carriers of the protective INS variant than those without it (4 of 83 [4.8%] vs. 31 of 260 [11.9%]; p = 0.032; 26.1 ± 3.9 and 26.3 ± 4.1 years follow-up, respectively), whereas DKD frequencies were no different between those with or without this variant (5 of 83 [6.0%] vs. 11 of 260 [4.2%]). Carrying a copy of this protective INS variant further reduces the risk of diabetic complications achieved by intensive insulin therapy and marks a disease endotype with superior glycemic control, increased and extended beta cell function, and prevention of DKD and PDR. Public Library of Science 2023-01-26 /pmc/articles/PMC9879388/ /pubmed/36701305 http://dx.doi.org/10.1371/journal.pone.0280872 Text en © 2023 van Tienhoven et al https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. |
spellingShingle | Research Article van Tienhoven, René Vu, Anh Nguyet Kaddis, John S. Roep, Bart O. Low risk for diabetic complications in type 1 diabetes patients carrying a protective insulin gene variant |
title | Low risk for diabetic complications in type 1 diabetes patients carrying a protective insulin gene variant |
title_full | Low risk for diabetic complications in type 1 diabetes patients carrying a protective insulin gene variant |
title_fullStr | Low risk for diabetic complications in type 1 diabetes patients carrying a protective insulin gene variant |
title_full_unstemmed | Low risk for diabetic complications in type 1 diabetes patients carrying a protective insulin gene variant |
title_short | Low risk for diabetic complications in type 1 diabetes patients carrying a protective insulin gene variant |
title_sort | low risk for diabetic complications in type 1 diabetes patients carrying a protective insulin gene variant |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9879388/ https://www.ncbi.nlm.nih.gov/pubmed/36701305 http://dx.doi.org/10.1371/journal.pone.0280872 |
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