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Islet cell antibodies and fasting C-peptide predict insulin requirement at diagnosis of diabetes mellitus

Landin-Olsson, M. LU ; Nilsson, K. O. LU ; Lernmark, Å LU and Sundkvist, G. LU (1990) In Diabetologia 33(9). p.561-568
Abstract

The differential diagnosis between Type 1 (insulin-dependent) and Type 2 (non-insulin-dependent) diabetes is complicated since no specific markers are available for either disease. In this study, 244 consecutive patients were diagnosed with diabetes mellitus during two years in Malmö (230000 inhabitants), corresponding to an incidence rate of 53·100000-1·year-1. Age, body mass index, HbA1c, C-peptide, and levels of islet cell antibodies were determined at the clinical onset, and related to the classification at diagnosis and at follow-up (n=233) after a median time of 31 (range 1-49) months. After diagnosis, 42 of 244 (17%) were started on insulin while 202 of 244 (83%) were not. Islet cell antibodies... (More)

The differential diagnosis between Type 1 (insulin-dependent) and Type 2 (non-insulin-dependent) diabetes is complicated since no specific markers are available for either disease. In this study, 244 consecutive patients were diagnosed with diabetes mellitus during two years in Malmö (230000 inhabitants), corresponding to an incidence rate of 53·100000-1·year-1. Age, body mass index, HbA1c, C-peptide, and levels of islet cell antibodies were determined at the clinical onset, and related to the classification at diagnosis and at follow-up (n=233) after a median time of 31 (range 1-49) months. After diagnosis, 42 of 244 (17%) were started on insulin while 202 of 244 (83%) were not. Islet cell antibodies were present in 25 of 42 (60%), and in 18 of 183 (10%), respectively. In the non-insulin treated group, patients with islet cell antibodies had lower body mass index (p<0.001), higher HbA1c (p<0.004), and lower C-peptide (p<0.001) than patients without. At follow-up, 11 of 18 (61%) islet cell positive patients were changed to insulin treatment, as were six other patients. Insulin was discontinued in five initially insulin-treated but islet cell antibody negative patients. The sensitivity, specificity and predictive value for insulin treatment at follow-up were for islet cell antibody positivity; 72%, 96% and 84%, respectively, and for low C-peptide value; 60%, 96%, and 80%, respectively. Islet cell antibodies and low C-peptide at diagnosis of diabetes mellitus are concluded to be useful markers to predict insulin dependence.

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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
age, body mass index, HbA, incidence, Type 1 (insulin-dependent) diabetes, Type 2 (non-insulin dependent) diabetes
in
Diabetologia
volume
33
issue
9
pages
8 pages
publisher
Springer
external identifiers
  • scopus:0025109113
  • pmid:2253834
ISSN
0012-186X
DOI
10.1007/BF00404145
language
English
LU publication?
yes
id
83514e12-10af-415a-a0f3-7c59ac28283b
date added to LUP
2019-09-11 09:55:23
date last changed
2019-11-25 09:34:16
@article{83514e12-10af-415a-a0f3-7c59ac28283b,
  abstract     = {<p>The differential diagnosis between Type 1 (insulin-dependent) and Type 2 (non-insulin-dependent) diabetes is complicated since no specific markers are available for either disease. In this study, 244 consecutive patients were diagnosed with diabetes mellitus during two years in Malmö (230000 inhabitants), corresponding to an incidence rate of 53·100000<sup>-1</sup>·year<sup>-1</sup>. Age, body mass index, HbA<sub>1c</sub>, C-peptide, and levels of islet cell antibodies were determined at the clinical onset, and related to the classification at diagnosis and at follow-up (n=233) after a median time of 31 (range 1-49) months. After diagnosis, 42 of 244 (17%) were started on insulin while 202 of 244 (83%) were not. Islet cell antibodies were present in 25 of 42 (60%), and in 18 of 183 (10%), respectively. In the non-insulin treated group, patients with islet cell antibodies had lower body mass index (p&lt;0.001), higher HbA<sub>1c</sub> (p&lt;0.004), and lower C-peptide (p&lt;0.001) than patients without. At follow-up, 11 of 18 (61%) islet cell positive patients were changed to insulin treatment, as were six other patients. Insulin was discontinued in five initially insulin-treated but islet cell antibody negative patients. The sensitivity, specificity and predictive value for insulin treatment at follow-up were for islet cell antibody positivity; 72%, 96% and 84%, respectively, and for low C-peptide value; 60%, 96%, and 80%, respectively. Islet cell antibodies and low C-peptide at diagnosis of diabetes mellitus are concluded to be useful markers to predict insulin dependence.</p>},
  author       = {Landin-Olsson, M. and Nilsson, K. O. and Lernmark, Å and Sundkvist, G.},
  issn         = {0012-186X},
  language     = {eng},
  month        = {09},
  number       = {9},
  pages        = {561--568},
  publisher    = {Springer},
  series       = {Diabetologia},
  title        = {Islet cell antibodies and fasting C-peptide predict insulin requirement at diagnosis of diabetes mellitus},
  url          = {http://dx.doi.org/10.1007/BF00404145},
  doi          = {10.1007/BF00404145},
  volume       = {33},
  year         = {1990},
}