Type 1 Diabetes, Immunology, Genetics & Endogenous Insulin Production (TIGI)
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Type I diabetes(T1D)T occurs when an individual loses the ability to make enough insulin to control their blood sugar levels. They need insulin injections to replace the insulin production that has been lost. Traditionally people with T1D are thought to make none of their own insulin after diagnosis, but we have recently identified that there are some people who have T1D but go one making insulin for many years. We would like to explore this in more depth and understand why some people with T1D go on making insulin and some do not. This will help us understand the causes of T1D and may help work out ways to protect this remaining insulin production, with improved blood sugar control, and reduced long-term complications of diabetes We aim to explore genetic and immunological factors which impact on the ability of an individual diagnosed with Type I diabetes (T1D) to produce their own insulin. We aim to study individuals who have been diagnosed with T1D with variable duration and assess the genetic and immunological profile of those whose are thought to be producing significant amounts of insulin despite a long duration and those who despite a very short duration, lose insulin production very quickly.
Difference in immune function in Cpeptide negative and positive [ Time Frame: Within 6 months of last participant visit ]
The frequency or suppressive function of regulatory T-cells and the frequency of auto reactive CD4 and CD8 T cells between C-peptide positive and C-peptide negative groups, (with patients and controls individually matched for age of diagnosis and duration).
Secondary Outcome Measures :
Difference in HLA type in Cpeptide negative and positive groups [ Time Frame: Within 6 months of last participant visit ]
The frequency of high and low risk HLA types and the frequency of non-HLA gene polymorphisms associated with T1D risk, between C-peptide positive, and C-peptide negative groups.
Biospecimen Retention: Samples With DNA
Peripheral Blood Mononuclear Cells (PBMCs) DNA Serum Plasma Urine
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Layout table for eligibility information
Ages Eligible for Study:
5 Years to 65 Years (Child, Adult, Older Adult)
Sexes Eligible for Study:
Accepts Healthy Volunteers:
All potential participants will be identified from either routine clinical care or from existing research cohorts managed by the Peninsula Research Bank as part of the NIHR Exeter Clinical Research Facility (ECRF). Potential participants who appear to meet the entry criteria will be given written information on the project, followed by the opportunity to discuss the project in more detail with a member of the research team. The research team will be responsible for the recruitment process.
Clinical diagnosis of Type 1 diabetes
Known UCPCR status (positive/negative defined by UCPCR cut off of 0.2nmol/mmol)
Age 5-65 years inclusive
Able and willing to provide informed consent/assent
Pregnant or lactating (as this may limit blood sampling and affect T cell function)
Any infectious illness within the last 2 weeks if it was a febrile illness, or within 2-3 days if it was non-febrile (as this may activate T cells non-specifically)
Taking steroids or other immunosuppressive medications (as these may alter T cell function)
Received any immunoglobulin treatments or blood products in the last 3 months (as these may alter T cell function)
Any other medical condition which, in the opinion of the investigator, would affect the safety of the subject's participation.
Recreational drug or alcohol abuse (excluding cannabis use more than 1 week prior to blood sampling) - drug abuse may alter T cell function.
Severe complications of diabetes other than background retinopathy, uncomplicated neuropathy or proteinuria with creatinine in normal reference range (as more severe complications may affect T cell function)