{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,27]],"date-time":"2026-09-27T14:05:21Z","timestamp":1790517921994,"version":"4.1.0"},"reference-count":30,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2022,10,30]],"date-time":"2022-10-30T00:00:00Z","timestamp":1667088000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000361","name":"Diabetes UK","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000361","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000901","name":"Juvenile Diabetes Research Foundation International","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000901","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Diabet Med"],"published-print":{"date-parts":[[2022,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aims<\/jats:title><jats:p>Some childhood type 1 diabetes cases are islet autoantibody negative at diagnosis. Potential explanations include misdiagnosis of genetic forms of diabetes or insufficient islet autoantibody testing. Many NHS laboratories offer combinations of three autoantibody markers. We sought to determine the benefit of testing for additional islet autoantibodies, including insulin (IAA) and tetraspanin 7 (TSPAN7A).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Radiobinding assays (RBAs) were used to test for four islet autoantibodies in children with newly diagnosed type 1 diabetes (<jats:italic>n<\/jats:italic>\u00a0=\u00a0486; 54.1% male; median age 10.4\u2009years [range 0.7\u201318.0]; median duration 1\u00a0day [range \u2212183 to 14]). Islet autoantibody negative children were tested for TSPAN7A using a luminescence\u2010based test. Where available, islet cell antibody (ICA) and human leucocyte antigen (HLA) data were considered.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Using three autoantibody markers, 21\/486 (4.3%) children were autoantibody negative. Testing for IAA classified a further 9\/21 (42.9%) children as autoantibody positive. Of the remaining 12 (2.5%) autoantibody negative children, all were TPAN7A negative, seven were ICA negative and one was positive for the protective variant <jats:italic>DQB1*0602.<\/jats:italic> One was subsequently diagnosed with Maturity Onset of Diabetes in the Young, but follow\u2010up was not available in all cases.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Using highly sensitive assays, testing for three autoantibodies fails to detect islet autoimmunity in approximately 1\/20 children diagnosed with type 1 diabetes. Testing for IAA in children &lt;5\u2009years and GADA in those &gt;10\u2009years was the most effective strategy for detecting islet autoimmunity. The ability to test for all islet autoantibodies should inform clinical decisions and make screening for monogenic diabetes more cost\u2010effective.<\/jats:p><\/jats:sec>","DOI":"10.1111\/dme.14979","type":"journal-article","created":{"date-parts":[[2022,10,17]],"date-time":"2022-10-17T16:31:46Z","timestamp":1666024306000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":18,"title":["The measurement of autoantibodies to insulin informs diagnosis of diabetes in a childhood population negative for other autoantibodies"],"prefix":"10.1111","volume":"39","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6641-8018","authenticated-orcid":false,"given":"Claire L.","family":"Williams","sequence":"first","affiliation":[{"name":"Diabetes and Metabolism, Bristol Medical School, University of Bristol, Southmead Hospital  Bristol UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rachel J.","family":"Aitken","sequence":"additional","affiliation":[{"name":"Diabetes and Metabolism, Bristol Medical School, University of Bristol, Southmead Hospital  Bristol UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isabel V.","family":"Wilson","sequence":"additional","affiliation":[{"name":"Diabetes and Metabolism, Bristol Medical School, University of Bristol, Southmead Hospital  Bristol UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3759-399X","authenticated-orcid":false,"given":"Georgina L. M.","family":"Mortimer","sequence":"additional","affiliation":[{"name":"Diabetes and Metabolism, Bristol Medical School, University of Bristol, Southmead Hospital  Bristol UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6847-2771","authenticated-orcid":false,"given":"Anna E.","family":"Long","sequence":"additional","affiliation":[{"name":"Diabetes and Metabolism, Bristol Medical School, University of Bristol, Southmead Hospital  Bristol UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3615-3899","authenticated-orcid":false,"given":"Alistair J. 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