What Proportion of Antibody-Negative Type 1 Diabetes Cases Have a Nonautoimmune Etiology? A Genetics-Based Estimate.

Accurate diagnosis of diabetes has important therapeutic consequences, yet 10-15% of individuals with type 1 diabetes are autoantibody negative, leaving the etiology of diabetes unconfirmed. We estimated what proportion of autoantibody negative, clinically diagnosed type 1 diabetes is misdiagnosed nonautoimmune diabetes. Upwards of 7.6% of autoantibody negative individuals are nonautoimmune. Our findings support the use of autoantibody screening and genetic testing of autoantibody negative patients as standard of care for type 1 diabetes.