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Glutamic acid decarboxylase antibodies (GADA) is the most important factor for prediction of insulin therapy within 3 years in young adult diabetic patients not classified as Type 1 diabetes on clinical grounds

Törn, Carina LU ; Landin-Olsson, Mona LU ; Östman, Jan; Scherstén, Bengt LU ; Arnqvist, Hans; Blohmé, Göran; Björk, Elisabeth; Bolinder, Jan; Eriksson, Jan and Littorin, Bengt LU , et al. (2000) In Diabetes/Metabolism Research and Reviews 16(6). p.442-447
Abstract

Background Differentiation between Type 1 and Type 2 diabetes in adults is difficult at diagnosis. In this study we tested the hypothesis that autoantibodies at diagnosis are predictive for insulin treatment within 3 years in patients initially not classified as Type 1 diabetes. Methods In a nationwide population-based study, blood samples were obtained from 764 patients, all diagnosed with diabetes during a 2-year period. At diagnosis, 583 (76%) were classified as Type 1, 110 (14%) as Type 2 and 71 (9.3%) could not be classified. Results Among patients not classified as Type 1 diabetes, 52 (47%) of Type 2 and 42 (59%) of unclassified patients were positive for islet cell antibodies CICA), glutamic acid decarboxylase antibodies (GADA)... (More)

Background Differentiation between Type 1 and Type 2 diabetes in adults is difficult at diagnosis. In this study we tested the hypothesis that autoantibodies at diagnosis are predictive for insulin treatment within 3 years in patients initially not classified as Type 1 diabetes. Methods In a nationwide population-based study, blood samples were obtained from 764 patients, all diagnosed with diabetes during a 2-year period. At diagnosis, 583 (76%) were classified as Type 1, 110 (14%) as Type 2 and 71 (9.3%) could not be classified. Results Among patients not classified as Type 1 diabetes, 52 (47%) of Type 2 and 42 (59%) of unclassified patients were positive for islet cell antibodies CICA), glutamic acid decarboxylase antibodies (GADA) or tyrosine phosphatase antibodies (IA-2A). These patients (n=94) had lower body mass index (BMI) (p<0.001) and lower C-peptide (p<0.001) compared to the autoantibody negative patients (n=87). Compared to clinically classified Type 1 diabetes patients positive for autoantibodies (n=477), they have higher BMI (p<0.001), higher C-peptide (p<0.001) and the same levels of ICA, GADA and IA-2A. After 3 years, 93% of autoantibody positive patients initially not classified as Type 1 were on insulin. When ICA, GADA, IA-2A, BMI and C-peptide were tested in a multiple logistic regression, only GADA was signiificant for insulin treatment within 3 years (OR = 18.8; 95% CI 1.8-191) in patients treated with diet or oral drugs at diagnosis. Conclusions A correct classification is difficult in adult diabetic patients. The presence of pancreatic autoantibodies, especially GADA, at diagnosis of diabetes are highly predictive for insulin therapy within 3 years from diagnosis. Copyright © 2000 John Wiley & Sons, Ltd.

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published
subject
keywords
Body mass index (BMI), C-peptide, Diabetes classification, GADA, IA-2A, ICA
in
Diabetes/Metabolism Research and Reviews
volume
16
issue
6
pages
6 pages
publisher
John Wiley & Sons
external identifiers
  • scopus:0034508418
ISSN
1520-7552
DOI
10.1002/1520-7560(2000)9999:9999<::AID-DMRR152>3.0.CO;2-T
language
English
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yes
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9e0df226-9509-4419-9807-ffe09cd5f764
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2017-09-07 08:55:26
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2017-09-07 08:55:26
@article{9e0df226-9509-4419-9807-ffe09cd5f764,
  abstract     = {<p>Background Differentiation between Type 1 and Type 2 diabetes in adults is difficult at diagnosis. In this study we tested the hypothesis that autoantibodies at diagnosis are predictive for insulin treatment within 3 years in patients initially not classified as Type 1 diabetes. Methods In a nationwide population-based study, blood samples were obtained from 764 patients, all diagnosed with diabetes during a 2-year period. At diagnosis, 583 (76%) were classified as Type 1, 110 (14%) as Type 2 and 71 (9.3%) could not be classified. Results Among patients not classified as Type 1 diabetes, 52 (47%) of Type 2 and 42 (59%) of unclassified patients were positive for islet cell antibodies CICA), glutamic acid decarboxylase antibodies (GADA) or tyrosine phosphatase antibodies (IA-2A). These patients (n=94) had lower body mass index (BMI) (p&lt;0.001) and lower C-peptide (p&lt;0.001) compared to the autoantibody negative patients (n=87). Compared to clinically classified Type 1 diabetes patients positive for autoantibodies (n=477), they have higher BMI (p&lt;0.001), higher C-peptide (p&lt;0.001) and the same levels of ICA, GADA and IA-2A. After 3 years, 93% of autoantibody positive patients initially not classified as Type 1 were on insulin. When ICA, GADA, IA-2A, BMI and C-peptide were tested in a multiple logistic regression, only GADA was signiificant for insulin treatment within 3 years (OR = 18.8; 95% CI 1.8-191) in patients treated with diet or oral drugs at diagnosis. Conclusions A correct classification is difficult in adult diabetic patients. The presence of pancreatic autoantibodies, especially GADA, at diagnosis of diabetes are highly predictive for insulin therapy within 3 years from diagnosis. Copyright © 2000 John Wiley &amp; Sons, Ltd.</p>},
  author       = {Törn, Carina and Landin-Olsson, Mona and Östman, Jan and Scherstén, Bengt and Arnqvist, Hans and Blohmé, Göran and Björk, Elisabeth and Bolinder, Jan and Eriksson, Jan and Littorin, Bengt and Nyström, Lennarth and Sundkvist, Göran and Lernmark, Åke},
  issn         = {1520-7552},
  keyword      = {Body mass index (BMI),C-peptide,Diabetes classification,GADA,IA-2A,ICA},
  language     = {eng},
  number       = {6},
  pages        = {442--447},
  publisher    = {John Wiley & Sons},
  series       = {Diabetes/Metabolism Research and Reviews},
  title        = {Glutamic acid decarboxylase antibodies (GADA) is the most important factor for prediction of insulin therapy within 3 years in young adult diabetic patients not classified as Type 1 diabetes on clinical grounds},
  url          = {http://dx.doi.org/10.1002/1520-7560(2000)9999:9999<::AID-DMRR152>3.0.CO;2-T},
  volume       = {16},
  year         = {2000},
}