Publication Description
Aims To determine if the presence of diabetes autoantibodies predicts the development of diabetes among participants in the Diabetes Prevention Program. Methods A total of 3050 participants were randomized into three treatment groups: intensive lifestyle intervention, metformin and placebo. Glutamic acid decarboxylase (GAD) 65 autoantibodies and insulinoma‐associated‐2 autoantibodies were measured at baseline and participants were followed for 3.2 years for the development of diabetes. Results The overall prevalence of GAD autoantibodies was 4.0%, and it varied across racial/ethnic groups from 2.4% among Asian‐Pacific Islanders to 7.0% among non‐Hispanic black people. There were no significant differences in BMI or metabolic variables (glucose, insulin, HbA1c, estimated insulin resistance, corrected insulin response) stratified by baseline GAD antibody status. GAD autoantibody positivity did not predict diabetes overall (adjusted hazard ratio 0.98; 95% CI 0.56–1.73) or in any of the three treatment groups. Insulinoma‐associated‐2 autoantibodies were positive in only one participant (0.033%). Conclusions These data suggest that ‘diabetes autoimmunity’, as reflected by GAD antibodies and insulinoma‐associated‐2 autoantibodies, in middle‐aged individuals at risk for diabetes is not a clinically relevant risk factor for progression to diabetes. What's new? It is unclear whether diabetes autoantibodies predict Type 2 diabetes among people with pre‐diabetes (impaired fasting glucose and impaired glucose intolerance), especially in minority populations. Diabetes autoantibodies (such as glutamic acid decarboxylase autoantibodies and insulinoma‐associated‐2 autoantibodies) were measured at baseline in the Diabetes Prevention Program and participants were followed for 3 years. Diabetes autoantibodies did not predict the development of diabetes in any treatment or race/ethnic group. Measuring diabetes autoantibodies in middle‐aged adults at high risk is not clinically useful for diabetes prediction.