Relation between Course of Disease in Type 1 Diabetes and Islet Cell Antibodies

Zamaklar, M.; Jotić, Aleksandra; Lalić, Nebojša; Lalić, Katarina; Rajković, N.; Miličić, Tanja

doi:10.1111/j.1749-6632.2002.tb02980.x

Cited by 14 publications

(12 citation statements)

References 6 publications

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“…Biochemical autoantibody measurements have become the mainstay for identifying autoimmune disease in patients with diabetes (28). The threshold for a positive response in these assays has been set to have a falsepositive rate of Ͻ1% in normal control subjects, and previous DASP workshops have shown that the median adjusted sensitivity for anti-GAD antibody was 84% and for ICA512 was 58%; all GAD65 and ICA512 assays found significant differences between patients and control subjects in that workshop (29,30).…”

Section: Discussionmentioning

confidence: 99%

Analysis of T-Cell Assays to Measure Autoimmune Responses in Subjects With Type 1 Diabetes

et al. 2006

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Type 1 diabetes is a chronic autoimmune disease mediated by autoreactive T-cells. Several experimental therapies targeting T-cells are in clinical trials. To understand how these therapies affect T-cell responses in vivo, assays that directly measure human T-cell function are needed. In a blinded, multicenter, case-controlled study conducted by the Immune Tolerance Network, we tested responses in an immunoblot and T-cell proliferative assay to distinguish type 1 diabetic patients from healthy control subjects. Peripheral blood cells from 39 healthy control subjects selected for DR4 and 23 subjects with recently diagnosed type 1 diabetes were studied. Autoantibody responses were measured in serum samples. Positive responses in both assays were more common in peripheral blood mononuclear cells from new-onset type 1 diabetic patients compared with control subjects. The proliferative, immunoblot, and autoantibody assays had sensitivities of 58, 91, and 78% with specificities of 94, 83, and 85%, respectively. When cellular assays were combined with autoantibody measurements, the sensitivity of the measurements was 75% with 100% specificity. We conclude that cellular assays performed on peripheral blood have a high degree of accuracy in discriminating responses in subjects with type 1 diabetes from healthy control subjects. They may be useful for assessment of cellular autoimmune responses involved in type 1 diabetes.

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Section: Discussionmentioning

confidence: 99%

Analysis of T-Cell Assays to Measure Autoimmune Responses in Subjects With Type 1 Diabetes

et al. 2006

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“…Hence, measurement of insulin in the peripheral blood does not accurately reflect endogenous insulin secretion. Most studies have approximated insulin secretion with C-peptide levels measured when fasting, at random, or following provocation with mixed meals or glucagon (13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25). While glucagon produces a reliable insulin response, it does not simulate normal physiology while a mixed meal is physiological.…”

mentioning

confidence: 99%

Insulin Secretion in Type 1 Diabetes

et al. 2004

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Type 1 diabetes, a chronic autoimmune disease, causes destruction of insulin-producing ␤-cells over a period of years. Although many markers of the autoimmune process have been described, none can convincingly predict the rate of disease progression. Moreover, there is relatively little information about changes in insulin secretion in individuals with type 1 diabetes over time. Previous studies document C-peptide at a limited number of time points, often after a nonphysiologic stimulus, and under non-steady-state conditions. Such methods do not provide qualitative information and may not reflect physiologic responses. We have studied qualitative and quantitative insulin secretion to a 4-h mixed meal in 41 patients with newly diagnosed type 1 diabetes and followed the course of this response for 24 months in 20 patients. Newly diagnosed diabetic patients had an average total insulin secretion in response to a mixed meal that was 52% of that in nondiabetic control subjects, considerably higher than has been described previously. In diabetic patients there was a decline of ␤-cell function at an average rate of 756 ؎ 132 pmol/month to a final value of 28 ؎ 8.4% of initial levels after 2 years. There was a significant correlation between the total insulin secretory response and control of glucose, measured by HbA 1c (P ‫؍‬ 0.003). Two persistent patterns of insulin response were seen depending on the peak insulin response following the oral meal. Patients with an early insulin response (i.e., within the first 45 min after ingestion) to a mixed meal, which was also seen in 37 of 38 nondiabetic control subjects, had a significantly accelerated loss of insulin secretion, as compared with those in whom the insulin response occurred after this time (P < 0.05), and significantly greater insulin secretory responses at 18 and 24 months (P < 0.02). These results, which are the first qualitative studies of insulin secretion in type 1 diabetes, indicate that the physiologic metabolic response is greater at diagnosis than has previously been appreciated, and that the qualitative insulin secretory response is an important determinant of the rate of metabolic decompensation from autoimmune destruction. Diabetes 53: 426 -433, 2004

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“…There is some evidence that higher number of detectable autoantibodies is related to more aggressive β-cell destruction and shorter duration of remission [24,30]. Participants were limited to hospital in-patient which may have introduced selection bias.…”

Section: Discussionmentioning

confidence: 99%

Factors associated with early beginning of partial remission in young adult patients with newly diagnosed type 1 diabetes

Piłaciński

Zozulińska‐Ziółkiewicz

Uruski

et al. 2015

Int J Diabetes Dev Ctries

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Clinical remission of type 1 diabetes reflects the transient recovery of β-cell function and improvement in insulin sensitivity, occurring after introduction of insulin therapy. The aim of the study was to identify factors associated with early beginning of partial remission phase in patients with newly diagnosed type 1 diabetes. One hundred and sixteen patients (41 women and 75 men), aged 18-34 (mean age 23.8±8.7 years), were included into the study. Mean hospitalization time was 7±2 days. Early remission was defined as reaching total daily insulin dose <0.3 U/kg with correct glycaemia in 24-h (7-point) glycaemic profile before discharge from the hospital, with random serum Cpeptide above 0.5 μg/l. In group entering early remission (74 patients), significantly lower HbA1c values (9.6±2.6 vs. 11.5±4.5 %, p<0.001), higher body mass index (BMI) (21.9 ± 2.9 vs. 20.8 ± 4.2 kg/m 2 , p < 0.05), less frequent ketonuria (45 vs. 79 %, p<0.01) and diabetic ketoacidosis (11 vs. 26 %, p = 0.06) were recorded at diagnosis. The results indicate that degree and duration of metabolic disturbances are associated with early beginning of partial remission in young adults with newly diagnosed type 1 diabetes. Early onset of remission is common in this age group.

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Relation between Course of Disease in Type 1 Diabetes and Islet Cell Antibodies

Cited by 14 publications

References 6 publications

Analysis of T-Cell Assays to Measure Autoimmune Responses in Subjects With Type 1 Diabetes

Analysis of T-Cell Assays to Measure Autoimmune Responses in Subjects With Type 1 Diabetes

Insulin Secretion in Type 1 Diabetes

Factors associated with early beginning of partial remission in young adult patients with newly diagnosed type 1 diabetes

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