Identification of infants with increased type 1 diabetes genetic risk for enrollment into Primary Prevention Trials-GPPAD-02 study design and first results

Christiane Winkler; Florian Haupt; Martin Heigermoser; Jose Zapardiel-Gonzalo; Jasmin Ohli; Theresa Faure; Evdokia Kalideri; Angela Hommel; Petrina Delivani; Reinhard Berner; Olga Kordonouri; Frank Roloff; Thekla von dem Berge; Karin Lange; Mariusz Oltarzewski; Ryszard Glab; Agnieszka Szypowska; Matthew Snape; Manu Vatish; John A. Todd; Helena E. Larsson; Anita Ramelius; Jeanette A. Kordel; Kristina Casteels; Jasmin Paulus; Anette G. Ziegler; Ezio Bonifacio; Melanie Guendert; Stefanie Arnolds; Robin Assfalg; Corinna Barz; Karina Blasius; Cigdem Gezginci; Cordula Falk; Joerg Hasford; Bianca Hoefelschweiger; Verena Hoffmann; Manja Jolink; Nana Kwarteng; Ramona Lickert; Claudia Matzke; Rebecca Niewoehner; Michaela Ott; Peter Ruile; Marlon Scholz; Katharina Schuette-Borkovec; Mira Taulien; Lorena Wendel; Katharina Wystub-Lis; Jose Maria Zapardiel Gonzalo; Goele Smeets; Hilde Morobe; Renka Van Heyste; Sophie Achten; Emma Lariviere; Janne Houben; Lionel Marcelis; Luc Regal; Uta Ceglarek; Sevina Dietz; Yannick Fuchs; Gita Gemulla; Manja Gottschalk; Sophie Heinke; Anne Karasinsky; Susann Kowal; Fabian Lander; Robert Morgenstern; Katharine Nitzsche; Bianca Schlee; Marina Stopsack; Marc Weigelt; Pauline Wimberger; Marie-Luise Zielmann; Nicole Zubizarreta; Torben Biester; Thomas Danne; Nils Janzen; Ute Holtkamp; Erika Marquardt; Kerstin Semler; Peter Achenbach; Melanie Bunk; Anita Gavrisan; Katharina Gestrich; Willi Graetz; Pascale Heim-Ohmayer; Melanie Herbst; Julia Hirte; Anna Hofelich; Cornelia Kraus; Yvonne Kriesen; Claudia Ramminger; Jennifer Schairer; Susanne Wittich; Stephanie Zillmer; Sylwia Dybkowska; Katarzyna Dzygalo; Lidia Groele; Karolina Dluzniak-Golaska; Dorota Owczarek; Katarzyna Popko; Agnieszka Skrobot; Anna Taczanowska; Beata Zdunczyk; Helena Elding Larsson; Markus Lundgren; Ake Lernmark; Daniel Agardh; Jeanette Akerstrom Kordel; Carin Andren Aronsson; Rasmus Bennet; Charlotte Brundin; Annika Fors; Lina Fransson; Berglind Jonsdottir; Ida Jonsson; Zeliha Mestan; Evelyn Tekum Amboh; Carina Torn; Matthew Snape; Owen Bendor-Samuel; James Bland; Edward Choi; Rachel Craik; Kimberly Davis; Arancha de la Horra; Yama Farooq; Clare Scudder; Ian Smith; Louise Willis; Tabitha Wishlade

doi:10.1111/pedi.12870

Identification of infants with increased type 1 diabetes genetic risk for enrollment into Primary Prevention Trials-GPPAD-02 study design and first results

Christiane Winkler, Florian Haupt, Martin Heigermoser, Jose Zapardiel-Gonzalo, Jasmin Ohli, Theresa Faure, Evdokia Kalideri, Angela Hommel, Petrina Delivani, Reinhard Berner, Olga Kordonouri, Frank Roloff, Thekla von dem Berge, Karin Lange, Mariusz Oltarzewski, Ryszard Glab, Agnieszka Szypowska, Matthew Snape, Manu Vatish, John A. ToddHelena E. Larsson, Anita Ramelius, Jeanette A. Kordel, Kristina Casteels, Jasmin Paulus, Anette G. Ziegler, Ezio Bonifacio, Melanie Guendert, Stefanie Arnolds, Robin Assfalg, Corinna Barz, Karina Blasius, Cigdem Gezginci, Cordula Falk, Joerg Hasford, Bianca Hoefelschweiger, Verena Hoffmann, Manja Jolink, Nana Kwarteng, Ramona Lickert, Claudia Matzke, Rebecca Niewoehner, Michaela Ott, Peter Ruile, Marlon Scholz, Katharina Schuette-Borkovec, Mira Taulien, Lorena Wendel, Katharina Wystub-Lis, Jose Maria Zapardiel Gonzalo, Goele Smeets, Hilde Morobe, Renka Van Heyste, Sophie Achten, Emma Lariviere, Janne Houben, Lionel Marcelis, Luc Regal, Uta Ceglarek, Sevina Dietz, Yannick Fuchs, Gita Gemulla, Manja Gottschalk, Sophie Heinke, Anne Karasinsky, Susann Kowal, Fabian Lander, Robert Morgenstern, Katharine Nitzsche, Bianca Schlee, Marina Stopsack, Marc Weigelt, Pauline Wimberger, Marie-Luise Zielmann, Nicole Zubizarreta, Torben Biester, Thomas Danne, Nils Janzen, Ute Holtkamp, Erika Marquardt, Kerstin Semler, Peter Achenbach, Melanie Bunk, Anita Gavrisan, Katharina Gestrich, Willi Graetz, Pascale Heim-Ohmayer, Melanie Herbst, Julia Hirte, Anna Hofelich, Cornelia Kraus, Yvonne Kriesen, Claudia Ramminger, Jennifer Schairer, Susanne Wittich, Stephanie Zillmer, Sylwia Dybkowska, Katarzyna Dzygalo, Lidia Groele, Karolina Dluzniak-Golaska, Dorota Owczarek, Katarzyna Popko, Agnieszka Skrobot, Anna Taczanowska, Beata Zdunczyk, Helena Elding Larsson, Markus Lundgren, Ake Lernmark, Daniel Agardh, Jeanette Akerstrom Kordel, Carin Andren Aronsson, Rasmus Bennet, Charlotte Brundin, Annika Fors, Lina Fransson, Berglind Jonsdottir, Ida Jonsson, Zeliha Mestan, Evelyn Tekum Amboh, Carina Torn, Matthew Snape, Owen Bendor-Samuel, James Bland, Edward Choi, Rachel Craik, Kimberly Davis, Arancha de la Horra, Yama Farooq, Clare Scudder, Ian Smith, Louise Willis, Tabitha Wishlade

Onderzoeksoutput: Article › peer review

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Samenvatting

Primary prevention of type 1 diabetes (T1D) requires intervention in genetically at-risk infants. The Global Platform for the Prevention of Autoimmune Diabetes (GPPAD) has established a screening program, GPPAD-02, that identifies infants with a genetic high risk of T1D, enrolls these into primary prevention trials, and follows the children for beta-cell autoantibodies and diabetes. Genetic testing is offered either at delivery, together with the regular newborn testing, or at a newborn health care visits before the age of 5 months in regions of Germany (Bavaria, Saxony, Lower Saxony), UK (Oxford), Poland (Warsaw), Belgium (Leuven), and Sweden (Region Skåne). Seven clinical centers will screen around 330 000 infants. Using a genetic score based on 46 T1D susceptibility single-nucleotide polymorphisms (SNPs) or three SNPS and a first-degree family history for T1D, infants with a high (>10%) genetic risk for developing multiple beta-cell autoantibodies by the age of 6 years are identified. Screening from October 2017 to December 2018 was performed in 50 669 infants. The prevalence of high genetic risk for T1D in these infants was 1.1%. Infants with high genetic risk for T1D are followed up and offered to participate in a randomized controlled trial aiming to prevent beta-cell autoimmunity and T1D by tolerance induction with oral insulin. The GPPAD-02 study provides a unique path to primary prevention of beta-cell autoimmunity in the general population. The eventual benefit to the community, if successful, will be a reduction in the number of children developing beta-cell autoimmunity and T1D.

Originele taal-2	English
Pagina's (van-tot)	720-727
Aantal pagina's	8
Tijdschrift	Pediatric Diabetes
Volume	20
Nummer van het tijdschrift	6
DOI's	https://doi.org/10.1111/pedi.12870
Status	Published - sep. 2019

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10.1111/pedi.12870

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Winkler, C., Haupt, F., Heigermoser, M., Zapardiel-Gonzalo, J., Ohli, J., Faure, T., Kalideri, E., Hommel, A., Delivani, P., Berner, R., Kordonouri, O., Roloff, F., von dem Berge, T., Lange, K., Oltarzewski, M., Glab, R., Szypowska, A., Snape, M., Vatish, M., ... Wishlade, T. (2019). Identification of infants with increased type 1 diabetes genetic risk for enrollment into Primary Prevention Trials-GPPAD-02 study design and first results. Pediatric Diabetes, 20(6), 720-727. https://doi.org/10.1111/pedi.12870

@article{bb9281ff9ddf4066874c3e8438f20fd2,

title = "Identification of infants with increased type 1 diabetes genetic risk for enrollment into Primary Prevention Trials-GPPAD-02 study design and first results",

abstract = "Primary prevention of type 1 diabetes (T1D) requires intervention in genetically at-risk infants. The Global Platform for the Prevention of Autoimmune Diabetes (GPPAD) has established a screening program, GPPAD-02, that identifies infants with a genetic high risk of T1D, enrolls these into primary prevention trials, and follows the children for beta-cell autoantibodies and diabetes. Genetic testing is offered either at delivery, together with the regular newborn testing, or at a newborn health care visits before the age of 5 months in regions of Germany (Bavaria, Saxony, Lower Saxony), UK (Oxford), Poland (Warsaw), Belgium (Leuven), and Sweden (Region Sk{\aa}ne). Seven clinical centers will screen around 330 000 infants. Using a genetic score based on 46 T1D susceptibility single-nucleotide polymorphisms (SNPs) or three SNPS and a first-degree family history for T1D, infants with a high (>10%) genetic risk for developing multiple beta-cell autoantibodies by the age of 6 years are identified. Screening from October 2017 to December 2018 was performed in 50 669 infants. The prevalence of high genetic risk for T1D in these infants was 1.1%. Infants with high genetic risk for T1D are followed up and offered to participate in a randomized controlled trial aiming to prevent beta-cell autoimmunity and T1D by tolerance induction with oral insulin. The GPPAD-02 study provides a unique path to primary prevention of beta-cell autoimmunity in the general population. The eventual benefit to the community, if successful, will be a reduction in the number of children developing beta-cell autoimmunity and T1D.",

keywords = "beta-cell autoantibodies, genetic risk for type 1 diabetes, type 1 diabetes",

author = "Christiane Winkler and Florian Haupt and Martin Heigermoser and Jose Zapardiel-Gonzalo and Jasmin Ohli and Theresa Faure and Evdokia Kalideri and Angela Hommel and Petrina Delivani and Reinhard Berner and Olga Kordonouri and Frank Roloff and {von dem Berge}, Thekla and Karin Lange and Mariusz Oltarzewski and Ryszard Glab and Agnieszka Szypowska and Matthew Snape and Manu Vatish and Todd, {John A.} and Larsson, {Helena E.} and Anita Ramelius and Kordel, {Jeanette A.} and Kristina Casteels and Jasmin Paulus and Ziegler, {Anette G.} and Ezio Bonifacio and Melanie Guendert and Stefanie Arnolds and Robin Assfalg and Corinna Barz and Karina Blasius and Cigdem Gezginci and Cordula Falk and Joerg Hasford and Bianca Hoefelschweiger and Verena Hoffmann and Manja Jolink and Nana Kwarteng and Ramona Lickert and Claudia Matzke and Rebecca Niewoehner and Michaela Ott and Peter Ruile and Marlon Scholz and Katharina Schuette-Borkovec and Mira Taulien and Lorena Wendel and Katharina Wystub-Lis and Gonzalo, {Jose Maria Zapardiel} and Goele Smeets and Hilde Morobe and {Van Heyste}, Renka and Sophie Achten and Emma Lariviere and Janne Houben and Lionel Marcelis and Luc Regal and Uta Ceglarek and Sevina Dietz and Yannick Fuchs and Gita Gemulla and Manja Gottschalk and Sophie Heinke and Anne Karasinsky and Susann Kowal and Fabian Lander and Robert Morgenstern and Katharine Nitzsche and Bianca Schlee and Marina Stopsack and Marc Weigelt and Pauline Wimberger and Marie-Luise Zielmann and Nicole Zubizarreta and Torben Biester and Thomas Danne and Nils Janzen and Ute Holtkamp and Erika Marquardt and Kerstin Semler and Peter Achenbach and Melanie Bunk and Anita Gavrisan and Katharina Gestrich and Willi Graetz and Pascale Heim-Ohmayer and Melanie Herbst and Julia Hirte and Anna Hofelich and Cornelia Kraus and Yvonne Kriesen and Claudia Ramminger and Jennifer Schairer and Susanne Wittich and Stephanie Zillmer and Sylwia Dybkowska and Katarzyna Dzygalo and Lidia Groele and Karolina Dluzniak-Golaska and Dorota Owczarek and Katarzyna Popko and Agnieszka Skrobot and Anna Taczanowska and Beata Zdunczyk and Larsson, {Helena Elding} and Markus Lundgren and Ake Lernmark and Daniel Agardh and Kordel, {Jeanette Akerstrom} and Aronsson, {Carin Andren} and Rasmus Bennet and Charlotte Brundin and Annika Fors and Lina Fransson and Berglind Jonsdottir and Ida Jonsson and Zeliha Mestan and Amboh, {Evelyn Tekum} and Carina Torn and Matthew Snape and Owen Bendor-Samuel and James Bland and Edward Choi and Rachel Craik and Kimberly Davis and {de la Horra}, Arancha and Yama Farooq and Clare Scudder and Ian Smith and Louise Willis and Tabitha Wishlade",

year = "2019",

month = sep,

doi = "10.1111/pedi.12870",

language = "English",

volume = "20",

pages = "720--727",

journal = "Pediatric Diabetes",

issn = "1399-543X",

publisher = "Blackwell Munksgaard",

number = "6",

}

Winkler, C, Haupt, F, Heigermoser, M, Zapardiel-Gonzalo, J, Ohli, J, Faure, T, Kalideri, E, Hommel, A, Delivani, P, Berner, R, Kordonouri, O, Roloff, F, von dem Berge, T, Lange, K, Oltarzewski, M, Glab, R, Szypowska, A, Snape, M, Vatish, M, Todd, JA, Larsson, HE, Ramelius, A, Kordel, JA, Casteels, K, Paulus, J, Ziegler, AG, Bonifacio, E, Guendert, M, Arnolds, S, Assfalg, R, Barz, C, Blasius, K, Gezginci, C, Falk, C, Hasford, J, Hoefelschweiger, B, Hoffmann, V, Jolink, M, Kwarteng, N, Lickert, R, Matzke, C, Niewoehner, R, Ott, M, Ruile, P, Scholz, M, Schuette-Borkovec, K, Taulien, M, Wendel, L, Wystub-Lis, K, Gonzalo, JMZ, Smeets, G, Morobe, H, Van Heyste, R, Achten, S, Lariviere, E, Houben, J, Marcelis, L, Regal, L, Ceglarek, U, Dietz, S, Fuchs, Y, Gemulla, G, Gottschalk, M, Heinke, S, Karasinsky, A, Kowal, S, Lander, F, Morgenstern, R, Nitzsche, K, Schlee, B, Stopsack, M, Weigelt, M, Wimberger, P, Zielmann, M-L, Zubizarreta, N, Biester, T, Danne, T, Janzen, N, Holtkamp, U, Marquardt, E, Semler, K, Achenbach, P, Bunk, M, Gavrisan, A, Gestrich, K, Graetz, W, Heim-Ohmayer, P, Herbst, M, Hirte, J, Hofelich, A, Kraus, C, Kriesen, Y, Ramminger, C, Schairer, J, Wittich, S, Zillmer, S, Dybkowska, S, Dzygalo, K, Groele, L, Dluzniak-Golaska, K, Owczarek, D, Popko, K, Skrobot, A, Taczanowska, A, Zdunczyk, B, Larsson, HE, Lundgren, M, Lernmark, A, Agardh, D, Kordel, JA, Aronsson, CA, Bennet, R, Brundin, C, Fors, A, Fransson, L, Jonsdottir, B, Jonsson, I, Mestan, Z, Amboh, ET, Torn, C, Snape, M, Bendor-Samuel, O, Bland, J, Choi, E, Craik, R, Davis, K, de la Horra, A, Farooq, Y, Scudder, C, Smith, I, Willis, L & Wishlade, T 2019, 'Identification of infants with increased type 1 diabetes genetic risk for enrollment into Primary Prevention Trials-GPPAD-02 study design and first results', Pediatric Diabetes, vol. 20, nr. 6, blz. 720-727. https://doi.org/10.1111/pedi.12870

TY - JOUR

T1 - Identification of infants with increased type 1 diabetes genetic risk for enrollment into Primary Prevention Trials-GPPAD-02 study design and first results

AU - Winkler, Christiane

AU - Haupt, Florian

AU - Heigermoser, Martin

AU - Zapardiel-Gonzalo, Jose

AU - Ohli, Jasmin

AU - Faure, Theresa

AU - Kalideri, Evdokia

AU - Hommel, Angela

AU - Delivani, Petrina

AU - Berner, Reinhard

AU - Kordonouri, Olga

AU - Roloff, Frank

AU - von dem Berge, Thekla

AU - Lange, Karin

AU - Oltarzewski, Mariusz

AU - Glab, Ryszard

AU - Szypowska, Agnieszka

AU - Snape, Matthew

AU - Vatish, Manu

AU - Todd, John A.

AU - Larsson, Helena E.

AU - Ramelius, Anita

AU - Kordel, Jeanette A.

AU - Casteels, Kristina

AU - Paulus, Jasmin

AU - Ziegler, Anette G.

AU - Bonifacio, Ezio

AU - Guendert, Melanie

AU - Arnolds, Stefanie

AU - Assfalg, Robin

AU - Barz, Corinna

AU - Blasius, Karina

AU - Gezginci, Cigdem

AU - Falk, Cordula

AU - Hasford, Joerg

AU - Hoefelschweiger, Bianca

AU - Hoffmann, Verena

AU - Jolink, Manja

AU - Kwarteng, Nana

AU - Lickert, Ramona

AU - Matzke, Claudia

AU - Niewoehner, Rebecca

AU - Ott, Michaela

AU - Ruile, Peter

AU - Scholz, Marlon

AU - Schuette-Borkovec, Katharina

AU - Taulien, Mira

AU - Wendel, Lorena

AU - Wystub-Lis, Katharina

AU - Gonzalo, Jose Maria Zapardiel

AU - Smeets, Goele

AU - Morobe, Hilde

AU - Van Heyste, Renka

AU - Achten, Sophie

AU - Lariviere, Emma

AU - Houben, Janne

AU - Marcelis, Lionel

AU - Regal, Luc

AU - Ceglarek, Uta

AU - Dietz, Sevina

AU - Fuchs, Yannick

AU - Gemulla, Gita

AU - Gottschalk, Manja

AU - Heinke, Sophie

AU - Karasinsky, Anne

AU - Kowal, Susann

AU - Lander, Fabian

AU - Morgenstern, Robert

AU - Nitzsche, Katharine

AU - Schlee, Bianca

AU - Stopsack, Marina

AU - Weigelt, Marc

AU - Wimberger, Pauline

AU - Zielmann, Marie-Luise

AU - Zubizarreta, Nicole

AU - Biester, Torben

AU - Danne, Thomas

AU - Janzen, Nils

AU - Holtkamp, Ute

AU - Marquardt, Erika

AU - Semler, Kerstin

AU - Achenbach, Peter

AU - Bunk, Melanie

AU - Gavrisan, Anita

AU - Gestrich, Katharina

AU - Graetz, Willi

AU - Heim-Ohmayer, Pascale

AU - Herbst, Melanie

AU - Hirte, Julia

AU - Hofelich, Anna

AU - Kraus, Cornelia

AU - Kriesen, Yvonne

AU - Ramminger, Claudia

AU - Schairer, Jennifer

AU - Wittich, Susanne

AU - Zillmer, Stephanie

AU - Dybkowska, Sylwia

AU - Dzygalo, Katarzyna

AU - Groele, Lidia

AU - Dluzniak-Golaska, Karolina

AU - Owczarek, Dorota

AU - Popko, Katarzyna

AU - Skrobot, Agnieszka

AU - Taczanowska, Anna

AU - Zdunczyk, Beata

AU - Larsson, Helena Elding

AU - Lundgren, Markus

AU - Lernmark, Ake

AU - Agardh, Daniel

AU - Kordel, Jeanette Akerstrom

AU - Aronsson, Carin Andren

AU - Bennet, Rasmus

AU - Brundin, Charlotte

AU - Fors, Annika

AU - Fransson, Lina

AU - Jonsdottir, Berglind

AU - Jonsson, Ida

AU - Mestan, Zeliha

AU - Amboh, Evelyn Tekum

AU - Torn, Carina

AU - Snape, Matthew

AU - Bendor-Samuel, Owen

AU - Bland, James

AU - Choi, Edward

AU - Craik, Rachel

AU - Davis, Kimberly

AU - de la Horra, Arancha

AU - Farooq, Yama

AU - Scudder, Clare

AU - Smith, Ian

AU - Willis, Louise

AU - Wishlade, Tabitha

PY - 2019/9

Y1 - 2019/9

N2 - Primary prevention of type 1 diabetes (T1D) requires intervention in genetically at-risk infants. The Global Platform for the Prevention of Autoimmune Diabetes (GPPAD) has established a screening program, GPPAD-02, that identifies infants with a genetic high risk of T1D, enrolls these into primary prevention trials, and follows the children for beta-cell autoantibodies and diabetes. Genetic testing is offered either at delivery, together with the regular newborn testing, or at a newborn health care visits before the age of 5 months in regions of Germany (Bavaria, Saxony, Lower Saxony), UK (Oxford), Poland (Warsaw), Belgium (Leuven), and Sweden (Region Skåne). Seven clinical centers will screen around 330 000 infants. Using a genetic score based on 46 T1D susceptibility single-nucleotide polymorphisms (SNPs) or three SNPS and a first-degree family history for T1D, infants with a high (>10%) genetic risk for developing multiple beta-cell autoantibodies by the age of 6 years are identified. Screening from October 2017 to December 2018 was performed in 50 669 infants. The prevalence of high genetic risk for T1D in these infants was 1.1%. Infants with high genetic risk for T1D are followed up and offered to participate in a randomized controlled trial aiming to prevent beta-cell autoimmunity and T1D by tolerance induction with oral insulin. The GPPAD-02 study provides a unique path to primary prevention of beta-cell autoimmunity in the general population. The eventual benefit to the community, if successful, will be a reduction in the number of children developing beta-cell autoimmunity and T1D.

AB - Primary prevention of type 1 diabetes (T1D) requires intervention in genetically at-risk infants. The Global Platform for the Prevention of Autoimmune Diabetes (GPPAD) has established a screening program, GPPAD-02, that identifies infants with a genetic high risk of T1D, enrolls these into primary prevention trials, and follows the children for beta-cell autoantibodies and diabetes. Genetic testing is offered either at delivery, together with the regular newborn testing, or at a newborn health care visits before the age of 5 months in regions of Germany (Bavaria, Saxony, Lower Saxony), UK (Oxford), Poland (Warsaw), Belgium (Leuven), and Sweden (Region Skåne). Seven clinical centers will screen around 330 000 infants. Using a genetic score based on 46 T1D susceptibility single-nucleotide polymorphisms (SNPs) or three SNPS and a first-degree family history for T1D, infants with a high (>10%) genetic risk for developing multiple beta-cell autoantibodies by the age of 6 years are identified. Screening from October 2017 to December 2018 was performed in 50 669 infants. The prevalence of high genetic risk for T1D in these infants was 1.1%. Infants with high genetic risk for T1D are followed up and offered to participate in a randomized controlled trial aiming to prevent beta-cell autoimmunity and T1D by tolerance induction with oral insulin. The GPPAD-02 study provides a unique path to primary prevention of beta-cell autoimmunity in the general population. The eventual benefit to the community, if successful, will be a reduction in the number of children developing beta-cell autoimmunity and T1D.

KW - beta-cell autoantibodies

KW - genetic risk for type 1 diabetes

KW - type 1 diabetes

UR - http://www.scopus.com/inward/record.url?scp=85067356439&partnerID=8YFLogxK

U2 - 10.1111/pedi.12870

DO - 10.1111/pedi.12870

M3 - Article

SN - 1399-543X

VL - 20

SP - 720

EP - 727

JO - Pediatric Diabetes

JF - Pediatric Diabetes

IS - 6

ER -

Identification of infants with increased type 1 diabetes genetic risk for enrollment into Primary Prevention Trials-GPPAD-02 study design and first results

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