Clinical Evaluation of Non-Insulin-Dependent Diabetes Mellitus Patients with Autoantibodies to Glutamic Acid Decarboxylase

Abiru, Norio; Takino, Hirofumi; Yano, Mototake; Kawasaki, Eiji; Yamasaki, Hironori; Yamaguchi, Yoshihiko; Akazawa, Shoichi; Nagataki, Shigenobu

doi:10.1006/jaut.1996.0089

Cited by 38 publications

(30 citation statements)

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“…In our cross-sectional study, autoantibodies to GAD (GADAb) were detected in 3.8% of Japanese diabetic patients who had been treated with diet or oral hypoglycaemic agents for more than half a year after the onset of diabetes. Furthermore, 1.5% were both GADAb-positive and insulin-deficient [32]. Takeda and co-workers found a similar prevalence of GADAb in a larger population-based study, which analysed 4,980 patients with adult-onset diabetes aged >20 years [33].…”

Section: Adult Onset Type 1 Diabetesmentioning

confidence: 76%

Type 1 diabetes in Japan

2006

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Section: Adult Onset Type 1 Diabetesmentioning

confidence: 76%

Type 1 diabetes in Japan

2006

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“…11 Moreover, some reports suggested that ICA positivity in type 2 diabetes predicted future insulin requirement 17,18 and that GAD positivity correlated with a younger age of diagnosis, lower C-peptide at diagnosis, and increased probability of insulin requirement. 6,7,19 No differences in BMI or serum C-peptide levels could be found between GAD-positive and GAD-negative type 2 patients at diagnosis. 10 Of interest is 1 study showing that fasting C-peptide levels in ICA-positive patients with type 2 diabetes were similar to patients with type 1 diabetes, 3 years after diagnosis.…”

Section: Discussionmentioning

confidence: 90%

“…GAD positivity has been reported in 3.8% to 16.1% of patients with type 2 diabetes. [5][6][7][8][9][10][11] ICA prevalence in type 2 diabetes was reported as 1.6% in 1 study 5 and 4.8% in another. 11 Moreover, some reports suggested that ICA positivity in type 2 diabetes predicted future insulin requirement 17,18 and that GAD positivity correlated with a younger age of diagnosis, lower C-peptide at diagnosis, and increased probability of insulin requirement.…”

Section: Discussionmentioning

confidence: 93%

“…3,4 However, there are several reports in the adult literature describing and analyzing the incidence of diabetes autoimmune markers in type 2 diabetes in adults. [5][6][7][8][9][10][11] The objective of the present study was to outline the ethnic, familial, seasonal, and autoimmune marker characteristics of children and adolescents with type 2 diabetes at the Pediatric Diabetes Center of Loma Linda University.…”

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confidence: 99%

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Diabetic Autoimmune Markers in Children and Adolescents With Type 2 Diabetes

et al. 2001

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ABSTRACT.Background. There is an increase in the incidence of type 2 diabetes in children and adolescents. Absence of known diabetes autoimmune markers is sometimes required to confirm the diagnosis.Objective. To identify clinical and autoimmune characteristics of type 2 diabetes in a pediatric population.Method. We report an analysis of 48 children and adolescents with type 2 diabetes, compared with 39 randomly selected children with type 1 diabetes, diagnosed and followed at the Loma Linda University Pediatric Diabetes Center. Ethnic, familial, seasonal, and autoimmune marker characteristics are outlined. To determine the reliability of antibody testing in confirming the type of diabetes at diagnosis, we studied the incidence of positive islet cell antibodies (ICAs), glutamic acid decarboxylase antibodies (GADs), and insulin autoantibodies (IAAs) at diagnosis in both groups. ICA512, GADs, and IAAs were measured by radioimmunoassay.Results. The cohort with type 2 diabetes had a similar gender distribution as the group with type 1 diabetes but a significantly higher age at diagnosis. Ethnic background was significantly different between the 2 groups, predominantly Hispanic in type 2 and white in type 1. Body mass index was significantly higher in type 2 diabetes (mean ‫؍‬ 31.24 kg/m 2 ). Among the patients with type 2 diabetes, 33% presented in diabetic ketoacidosis, random blood glucose at diagnosis ranged from 11.4 to 22.25 mmol/L (228 -445 mg/dL), fasting C-peptide levels ranged from 0.89 to 2.7 nmol/L (2.7-8.2 ng/mL; normal: <1.36 nmol/L), and hemoglobin A 1C was 10.8 ؎ 3.5% (normal: <6.6%). None of these parameters was significantly different from the type 1 diabetes group. Although the incidence of diabetes antibody markers was significantly lower in type 2 versus type 1 diabetes, 8.1% of patients with type 2 diabetes had positive ICAs, 30.3% had positive GADs, and 34.8% had positive IAAs without ever being treated with insulin. In the type 2 diabetes group, none of the Hispanic patients had ICAs. However, there was no significant correlation between any of the diabetes antibodies and obesity, presence of acanthosis nigricans, or family history of diabetes. The frequency of thyroid antibodies was not significantly different from the group with type 1 diabetes. Daily insulin requirements 1 year after diagnosis were significantly lower in type 2 diabetes, ranging from 0 to 1.2 U/kg with a mean of 0.33. Conclusion.Absence of diabetes autoimmune markers is not a prerequisite for the diagnosis of type 2 diabetes in children and adolescents. Pediatrics 2001;107(6). URL: http://www.pediatrics.org/cgi/content/full/107/6/ e102; type 2 diabetes, adolescents, autoimmunity, islet cell antibodies, glutamic acid decarboxylase antibodies.

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“…A study in a group of Japanese patients who had been diagnosed initially with non-insulin dependent diabetes mellitus (NIDDM) showed that those with higher GADA titers progressed rapidly to an insulindependent state (28)(29)(30). However, in a study of stratification of diabetes risk in T1AD's first-degree relatives, it was found that high titers of IA2A and IAA, though not GADA, were associated with an increased risk for clinical diabetes (29).…”

Section: Discussionmentioning

confidence: 99%

Prevalence of pancreatic autoantibodies in non-diabetic patients with autoimmune thyroid disease and its relation to insulin secretion and glucose tolerance

Sallorenzo

Silva

Kasamatsu

et al. 2017

Arch. Endocrinol. Metab.

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Objective: We evaluated the prevalence of glutamic acid decarboxylase (GADA) and tyrosine phosphatase-protein antibodies (IA2A), their titers and their relation to first phase insulin response (FPIR) and glucose tolerance in autoimmune thyroid diseases (ATDs) patients. Subjects and methods: Graves' disease (GD; n = 181) and Hashimoto's thyroiditis (HT; n = 143) patients in addition to healthy controls (n = 93) were studied. Secondly, FPIR and oral glucose tolerance tests (OGTT) were performed in 11 anti-pancreatic islet-cell (+) and in 20 anti-pancreatic-cell (-) patients. Results: There was a non significant trend for higher prevalence of GADA positivity in GD vs HT (7.2% vs 2% p = 0.06), but the GADA titers were higher in HT. We also did not find a significant difference in IA2 prevalence (0.7% vs 0.0%) between these two groups or compared to the control group. In the subsequent analysis, low FPIR was found in 10% of these patients but without statistical difference for OGTT between pancreatic antibody-positive and -negative patients. Conclusion: A trend for greater prevalence of GADA was observed for GD patients than for HT or control. However, the titers of these autoantibodies were higher in HT patients, but there was no significant relation to insulin secretion and glucose tolerance at that moment and stage of autoimmune diseases. Arch Endocrinol Metab. 2017;61(3):361-6.

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Clinical Evaluation of Non-Insulin-Dependent Diabetes Mellitus Patients with Autoantibodies to Glutamic Acid Decarboxylase

Cited by 38 publications

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Type 1 diabetes in Japan

Type 1 diabetes in Japan

Diabetic Autoimmune Markers in Children and Adolescents With Type 2 Diabetes

Prevalence of pancreatic autoantibodies in non-diabetic patients with autoimmune thyroid disease and its relation to insulin secretion and glucose tolerance

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