Introduction & Objective: Type 1 diabetes (T1D) incidence continues to increase in children, especially among Hispanic Whites (HW). We investigated the clinical and immunologic characteristics of HW and Non-Hispanic White (NHW) children that presented at T1D diagnosis over the last two decades to the Barbara Davis Center for Diabetes.

Methods: In this single-center, observational study, children who were diagnosed with T1D (<u><</u>20 years old) and tested for islet autoantibodies within 1 year of diagnosis were included and divided into two groups by ethnicity.

Results: Of 1256 children, 401 HW children presented with a younger age at T1D onset, and more DKA compared to NHW children (n=855) (Table 1). There was no difference in sex, HbA1c levels, or the number and prevalence of islet autoantibodies between the two cohorts. A subset of our cohort was HLA-DR-DQ typed as specific alleles confer strong genetic risk for T1D (e.g., HLA-DR4 and DQ8). Among 556 HLA-typed children, HW children had a significantly higher prevalence of the DR4-DQ8 haplotype compared to NHW children (75.8% vs. 59.0%, p=0.002). Moreover, DR3-DQ2 was lower in HW compared to NHW T1D children (29.8% vs. 47.1%, p=0.001).

Conclusion: Hispanic White children developing T1D have a strikingly high prevalence of HLA DR4-DQ8, which can be utilized in screening for T1D risk to lessen DKA and potentially prevent diabetes onset.

Disclosure

K.E. Karakus: None. T. Fleury: None. E.E. Baschal: None. K. McDaniel: None. H. Choi: None. V. Langarica: None. L. Yu: None. K.M. Simmons: Advisory Panel; Provention Bio, Inc. Consultant; Provention Bio, Inc. Research Support; Provention Bio, Inc., Novartis AG. Consultant; Medtronic. A.W. Michels: Stock/Shareholder; IM Therapeutics. Advisory Panel; Provention Bio, Inc.

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