Objective: Over half of cases of type 1 diabetes are diagnosed in adults, yet the prevalence of islet autoantibodies (IA) in general population adults is unknown.

Methods: The Autoimmunity Screening for Kids (ASK) Study screened 1,087 adults (age 41±7 years, 78% female, 63% non-Hispanic white, 10% first-degree relatives) and 29,441 youth (age 1-17 years, 52%, 36%, and 5%, respectively) for IA to GAD, IA-2, insulin, and ZnT8 using electrochemiluminescence (ECL) or radiobinding assays (RBA).

Results: In adults, 3.9% screened positive; 0.6% were positive for multiple IA, 1.7% were positive for a single high-affinity IA, and 1.6% were positive for a single low-affinity IA. GADA was most prevalent, found in 2.7%. Unexpectedly, the prevalence of IA in adults and youth screened by ASK was not statistically different (Figure).

Conclusion: IA positivity is similar in youth and adults in the general population. Expanded access to type 1 diabetes screening and monitoring will aid in determining if early detection is similarly beneficial in adults as seen in youth, such as reducing rates of diabetic ketoacidosis at diagnosis of clinical type 1 diabetes.

Disclosure

M.Pauley: None. C.Geno rasmussen: None. F.Dong: None. K.M.Simmons: Advisory Panel; Provention Bio, Inc., Consultant; Dexcom, Inc., Provention Bio, Inc., Research Support; Novartis. M.Rewers: Research Support; Provention Bio, Juvenile Diabetes Research Foundation (JDRF), Hemsley Charitable Trust, Dexcom, Inc., Janssen Research & Development, LLC.

Funding

National Institute of Diabetes and Digestive and Kidney Diseases (T325T32DK063687); JDRF (2-SRA-2022-1270-S-B)

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