Vnitr Lek 1999, 45(2):97-102

[Latent autoimmune (Type-1) diabetes mellitus in adults. Part. I. Serologic markers of autoimmune involvement of pancreatic beta-cells: GADA, ICA, IA-2 a IA-A].

E Martinka, A Ocenásová, J Straková, M Mokán

I. interná klinika, JLF UK a MFN, Martin.

AIM: OF STUDY: To assess the prevalence of markers of autoimmune destruction of pancreatic beta-cells (AIDbeta) in patients classified initially as Type-2 diabetes mellitus (Type-2 DM).
SUBJECTS: 250 patients subdivided according to the: 1. BMI and C-peptide, 2. type of treatment. Measured parameters: age, BMI, C-peptide, autoantibodies directed against: glutamic acid decarboxylase (GADA), islet cells (ICA), thyrosinphosphatase (IA-2) and insulin (IA-A).

RESULTS: GADA (and other AIDbeta markers) positivity varied from < 5% in patients with overweight/obesity (> 27 kg.m(-2)) and normal/increased C-peptide (> 0.32 nmol/l) to > 30% in non-obese patients with low C-peptide.

CONCLUSION: Proportion of diabetics classified initially as having Type-2DM have had in fact slowly evolving autoimmune (Type-1) diabetes mellitus (LADA). In some patients both AID and insulin resistance may coexist in parallel. Pitfalls in interpretation of results of GADA, such as border positivity and similar, are discussed.

Keywords: Aged; Autoantibodies /analysis/; Autoimmune Diseases /diagnosis/; Biomarkers /analysis/; Diabetes Mellitus, Type 1 /diagnosis/; Diabetes Mellitus, Type 2 /diagnosis/; Diagnosis, Differential; Female; Glutamate Decarboxylase /immunology/; Humans; Insulin Antibodies /analysis/; Islets of Langerhans /immunology/; Male; Protein Tyrosine Phosphatase, Non-Receptor Type 1; Protein Tyrosine Phosphatases /immunology/

Published: February 1, 1999  Show citation