ArticleJournal of the Endocrine Society2026
Intravenous Glucose Tolerance Tests in Predicting Diabetes Onset in APECED: A Retrospective Cohort Study.
Article in Journal of the Endocrine Society, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Context: Patients with autoimmune polyendocrinopathy-candidiasis-ectodermal dystrophy (APECED) require screening for endocrine manifestations, including diabetes mellitus (DM). Objective: This work aimed to describe changes in glucose homeostasis preceding DM onset in patients with APECED. Methods: A retrospective cohort study was conducted on 57 Finnish patients with APECED with at least 1 intravenous glucose tolerance test (IVGTT) performed between 1971 and 2001. Observations were compared between 2 groups: patients who developed DM (DM+) and those who did not (DM-). Main outcome measures included fasting plasma glucose (FPG), fasting plasma insulin (INS), fractional glucose removal rate (K Results: Sixty-five IVGTTs were performed for 13 DM+ patients (54% females) at age 6.3 to 45.4 years before type 1 DM diagnosis at a median age of 25.0 years (range, 7.2-45.4 years) and 185 for 44 DM- patients (59% females) at age 5.9 to 61.5 years. All FPG values were between 2.9 and 6.3 mmol/L. Median (interquartile range) INS was significantly higher for the DM+ group at 9.05 mIU/L (6.13-11.20) vs the DM- group 5.20 mIU/L (3.85-7.00; Conclusion: Glucose tolerance decreases with age in patients with APECED. IVGTT-derived markers of glucose tolerance are not predictive of DM in APECED.
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