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Ketoacidosis in young adults is not related to the islet antibodies at the diagnosis of Type 1 diabetes mellitus - A nationwide study

Östman, Jan; Landin-Olsson, M. LU ; Törn, C. LU ; Palmer, J.; Lernmark, A. LU ; Arnqvist, H; Björk, E.; Bolinder, J.; Blohmé, G and Eriksson, J., et al. (2000) In Diabetic Medicine 17(4). p.269-274
Abstract

Aims: To test the hypothesis that there is lower prevalence of islet antibodies in subjects with newly diagnosed Type 1 diabetes mellitus in young adulthood than in children is associated with less severe diabetes at time of diagnosis. Methods: This investigation was based on a nationwide study (Diabetes Incidence Study in Sweden) of 15-34-year-old newly diagnosed diabetic subjects. During 1992-1993, all diabetic subjects (excluding secondary and gestational diabetes) were reported on standardized forms, with information about clinical characteristics at diagnosis. The study examined islet cell antibodies (ICA) by indirect immunofluorescence, and autoantibodies to glutamic acid decarboxylase (GADA), tyrosine phosphatase- like antigen... (More)

Aims: To test the hypothesis that there is lower prevalence of islet antibodies in subjects with newly diagnosed Type 1 diabetes mellitus in young adulthood than in children is associated with less severe diabetes at time of diagnosis. Methods: This investigation was based on a nationwide study (Diabetes Incidence Study in Sweden) of 15-34-year-old newly diagnosed diabetic subjects. During 1992-1993, all diabetic subjects (excluding secondary and gestational diabetes) were reported on standardized forms, with information about clinical characteristics at diagnosis. The study examined islet cell antibodies (ICA) by indirect immunofluorescence, and autoantibodies to glutamic acid decarboxylase (GADA), tyrosine phosphatase- like antigen (IA-2A) and insulin (IAA) as well as C-peptide by radioimmunoassay. Results: Blood samples were available from 78 patients with diabetic ketoacidosis (DKA) and 517 non-acidotic patients. The prevalence of ICA (63% vs. 57%), GADA (63% vs. 66%), IA-2A (35% vs. 44%) and IAA (20% vs. 15%) were very similar in patients with or without DKA. The median levels of the four autoantibodies did not differ between the two groups. High blood glucose (P < 0.001) and low C-peptide levels (P < 0.001) were the only parameters found to be related to DKA. Conclusions: The similarities in findings of newly diagnosed diabetic patients with or without DKA regarding ICA, GADA, IA-2A and IAA suggest that there is no relationship between the expression of antigenicity and the severity of β-cell dysfunction. The lower prevalence of the four autoantibodies in 15-34-year-old diabetic subjects compared with previous findings in children is not explained by misclassification of diabetes type.

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Contribution to journal
publication status
published
subject
keywords
Blood glucose, C-Peptide, Type 1 diabetes mellitus, Type 2 diabetes mellitus
in
Diabetic Medicine
volume
17
issue
4
pages
6 pages
publisher
Wiley-Blackwell
external identifiers
  • scopus:0034061171
ISSN
0742-3071
DOI
10.1046/j.1464-5491.2000.00265.x
language
English
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yes
id
556191a5-a8d6-4886-8717-e7ff122bdda0
date added to LUP
2017-09-06 14:38:10
date last changed
2017-09-14 15:07:27
@article{556191a5-a8d6-4886-8717-e7ff122bdda0,
  abstract     = {<p>Aims: To test the hypothesis that there is lower prevalence of islet antibodies in subjects with newly diagnosed Type 1 diabetes mellitus in young adulthood than in children is associated with less severe diabetes at time of diagnosis. Methods: This investigation was based on a nationwide study (Diabetes Incidence Study in Sweden) of 15-34-year-old newly diagnosed diabetic subjects. During 1992-1993, all diabetic subjects (excluding secondary and gestational diabetes) were reported on standardized forms, with information about clinical characteristics at diagnosis. The study examined islet cell antibodies (ICA) by indirect immunofluorescence, and autoantibodies to glutamic acid decarboxylase (GADA), tyrosine phosphatase- like antigen (IA-2A) and insulin (IAA) as well as C-peptide by radioimmunoassay. Results: Blood samples were available from 78 patients with diabetic ketoacidosis (DKA) and 517 non-acidotic patients. The prevalence of ICA (63% vs. 57%), GADA (63% vs. 66%), IA-2A (35% vs. 44%) and IAA (20% vs. 15%) were very similar in patients with or without DKA. The median levels of the four autoantibodies did not differ between the two groups. High blood glucose (P &lt; 0.001) and low C-peptide levels (P &lt; 0.001) were the only parameters found to be related to DKA. Conclusions: The similarities in findings of newly diagnosed diabetic patients with or without DKA regarding ICA, GADA, IA-2A and IAA suggest that there is no relationship between the expression of antigenicity and the severity of β-cell dysfunction. The lower prevalence of the four autoantibodies in 15-34-year-old diabetic subjects compared with previous findings in children is not explained by misclassification of diabetes type.</p>},
  author       = {Östman, Jan and Landin-Olsson, M. and Törn, C. and Palmer, J. and Lernmark, A. and Arnqvist, H and Björk, E. and Bolinder, J. and Blohmé, G and Eriksson, J. and Littorin, B. and Nyström, L. and Scherstén, B. and Sundkvist, G. and Wibell, L.},
  issn         = {0742-3071},
  keyword      = {Blood glucose,C-Peptide,Type 1 diabetes mellitus,Type 2 diabetes mellitus},
  language     = {eng},
  number       = {4},
  pages        = {269--274},
  publisher    = {Wiley-Blackwell},
  series       = {Diabetic Medicine},
  title        = {Ketoacidosis in young adults is not related to the islet antibodies at the diagnosis of Type 1 diabetes mellitus - A nationwide study},
  url          = {http://dx.doi.org/10.1046/j.1464-5491.2000.00265.x},
  volume       = {17},
  year         = {2000},
}