The role of specific pancreatic antibodies in the differential diagnosis of complete clinical and laboratory remission of type 1 diabetes mellitus and MODY in children

BACKGROUND: T1D is characterized by autoimmune destruction of pancreatic β-cells, which develops due to genetic and environmental risk factors. Shortly after initiating the treatment with insulin, 80% children may require smaller doses insulin develop clinical laboratory remission disease so called «honeymoon». The issue whether there a need differential diagnosis between DM non-immune forms raises in cases preclinical for more than 6 months. AIM: To study clinical, immunological, characteristics phase MODY children, determine diagnostic criteria children. MATERIALS AND METHODS: A single-centre, cross sectional noncontrolled comparative two independent cohorts. Data 150 examined Endocrinology Research Center (January 2016–June 2021). First cohort included patients complete (n=36), second MODY, confirmed (n=114). RESULTS: median age diabetes manifestation was significantly higher — 11.25 years [8.33; 13.78] 7.5 [4.6; 12.2] (p=0.004). In level glycated hemoglobin 6.0% [5.6; 6.4], group 6.5% [6.2; 6.7] (p<0.001). Patients monogenic had impaired fasting glucose 6.27 mmol/l [5.38; 6.72], while normoglycemia 5.12 [4.17; 5.87]. oral tolerance test perform all patients, two-hour did not differ groups (p=0.08). strong family history registered often (93% vs. 66.7%). positive autoantibody titer detected (77.8%) (11.4%). addition, no 1 type autoantibodies MODY. CONCLUSION: Antibodies ZnT8 IA2 showed greatest significance long absents requirement mellitus. Genetic recommended seronegative cases. If only one AT detected, specialist should decide on do based comprehensive analysis patient’s clinic characteristics, including history, blood levels.