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Islet cell and glutamic acid decarboxylase antibodies present at diagnosis of diabetes predict the need for insulin treatment : A cohort study in young adults whose disease was initially labeled as type 2 or unclassifiable diabetes

Littorin, Bengt LU ; Sundkvist, Goran LU ; Hagopian, William ; Landin-Olsson, Mona LU ; Lernmark, Åke LU orcid ; Östman, Jan ; Arnqvist, Hans J. ; Blohme, Goran ; Bolinder, Jan and Eriksson, Jan W. , et al. (1999) In Diabetes Care 22(3). p.409-412
Abstract

OBJECTIVE - To clarify the predictive value of islet cell antibody (ICA) and GAD65 antibody (GADA) present at diagnosis with respect to the need for insulin treatment 6 years after diagnosis in young adults initially considered to have type 2 or unclassifiable diabetes. RESEARCH DESIGN AND METHODS - The patient material was representative of the entire Swedish population, consisting of patients who were 15-34 years old at diagnosis of diabetes in 1987-1988 but were not considered to have type 1 diabetes at onset. At follow-up, 6 years after the diagnosis, it was noted whether the patient was treated with insulin. The presence of ICA was determined by an immunofluorescence assay, and GADAs were measured by a radioligand assay. RESULTS -... (More)

OBJECTIVE - To clarify the predictive value of islet cell antibody (ICA) and GAD65 antibody (GADA) present at diagnosis with respect to the need for insulin treatment 6 years after diagnosis in young adults initially considered to have type 2 or unclassifiable diabetes. RESEARCH DESIGN AND METHODS - The patient material was representative of the entire Swedish population, consisting of patients who were 15-34 years old at diagnosis of diabetes in 1987-1988 but were not considered to have type 1 diabetes at onset. At follow-up, 6 years after the diagnosis, it was noted whether the patient was treated with insulin. The presence of ICA was determined by an immunofluorescence assay, and GADAs were measured by a radioligand assay. RESULTS - Six years after diagnosis, 70 of 97 patients were treated with insulin, and 27 of 97 patients were treated with oral drugs or diet alone. At diagnosis, ICAs and GADAs were present in 41 (59%) of 70 patients and 41 (60%) of 68 patients, respectively, of those now treated with insulin, compared with only 1 (4%) of 26 patients and 2 (7%) of 27 patients who were still not treated with insulin. For either ICA or GADA, the corresponding frequencies were 50 (74%) of 68 for patients who were later treated with insulin and 3 (12%) of 26 for those who were still not treated with insulin, respectively The sensitivity for later insulin treatment was highest (74%) for the presence of ICA or GADA, and the specificity was highest (100%) for ICA and GADA. The positive predictive value was 100% for the combination of ICA and GADA, 98% for ICA alone, and ~95% for GADA alone. CONCLUSIONS - Determination of the presence of ICA and GADA at diagnosis of diabetes improves the classification of diabetes and predicts the future need of insulin in young adults.

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organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Diabetes Care
volume
22
issue
3
pages
409 - 412
publisher
American Diabetes Association
external identifiers
  • pmid:10097919
  • scopus:0032972677
ISSN
0149-5992
DOI
10.2337/diacare.22.3.409
language
English
LU publication?
yes
id
4861c118-574b-4d22-b350-eca54d0664c4
date added to LUP
2019-06-30 23:30:52
date last changed
2024-03-13 08:16:46
@article{4861c118-574b-4d22-b350-eca54d0664c4,
  abstract     = {{<p>OBJECTIVE - To clarify the predictive value of islet cell antibody (ICA) and GAD65 antibody (GADA) present at diagnosis with respect to the need for insulin treatment 6 years after diagnosis in young adults initially considered to have type 2 or unclassifiable diabetes. RESEARCH DESIGN AND METHODS - The patient material was representative of the entire Swedish population, consisting of patients who were 15-34 years old at diagnosis of diabetes in 1987-1988 but were not considered to have type 1 diabetes at onset. At follow-up, 6 years after the diagnosis, it was noted whether the patient was treated with insulin. The presence of ICA was determined by an immunofluorescence assay, and GADAs were measured by a radioligand assay. RESULTS - Six years after diagnosis, 70 of 97 patients were treated with insulin, and 27 of 97 patients were treated with oral drugs or diet alone. At diagnosis, ICAs and GADAs were present in 41 (59%) of 70 patients and 41 (60%) of 68 patients, respectively, of those now treated with insulin, compared with only 1 (4%) of 26 patients and 2 (7%) of 27 patients who were still not treated with insulin. For either ICA or GADA, the corresponding frequencies were 50 (74%) of 68 for patients who were later treated with insulin and 3 (12%) of 26 for those who were still not treated with insulin, respectively The sensitivity for later insulin treatment was highest (74%) for the presence of ICA or GADA, and the specificity was highest (100%) for ICA and GADA. The positive predictive value was 100% for the combination of ICA and GADA, 98% for ICA alone, and ~95% for GADA alone. CONCLUSIONS - Determination of the presence of ICA and GADA at diagnosis of diabetes improves the classification of diabetes and predicts the future need of insulin in young adults.</p>}},
  author       = {{Littorin, Bengt and Sundkvist, Goran and Hagopian, William and Landin-Olsson, Mona and Lernmark, Åke and Östman, Jan and Arnqvist, Hans J. and Blohme, Goran and Bolinder, Jan and Eriksson, Jan W. and Lithner, Folke and Scherstén, Bengt and Wibell, Lars}},
  issn         = {{0149-5992}},
  language     = {{eng}},
  month        = {{01}},
  number       = {{3}},
  pages        = {{409--412}},
  publisher    = {{American Diabetes Association}},
  series       = {{Diabetes Care}},
  title        = {{Islet cell and glutamic acid decarboxylase antibodies present at diagnosis of diabetes predict the need for insulin treatment : A cohort study in young adults whose disease was initially labeled as type 2 or unclassifiable diabetes}},
  url          = {{http://dx.doi.org/10.2337/diacare.22.3.409}},
  doi          = {{10.2337/diacare.22.3.409}},
  volume       = {{22}},
  year         = {{1999}},
}