Diabetes-Related Autoantibodies in Diabetic Gastroparesis

Abstract

This pilot study demonstrated that of the three tested antibodies in long-term diabetic gastroparesis patients, GADA was the most prevalent positive antibody with no detection of ICA or IAA. Positive GADA was seen in 42 % of T1DM compared to 25 % of phenotypic T2DM. However, the presence of antibody was not associated with severity of gastric emptying or GI symptoms. Thus, detection of an autoimmune form of diabetes, primarily T1DM, should be investigated using GADA.

Significance of dynamic changes in gastric smooth muscle cell apoptosis, PI3K-AKT-mTOR and AMPK-mTOR signaling in a rat model of diabetic gastroparesis

“…Diabetic gastroparesis is a complex pathophysiological process (15). Investigations on the pathogenesis of diabetic gastroparesis predominantly focus on high blood sugar-induced neuropathy, stomach hormone secretion disorder, stress, and certain microvascular diseases (16,17), whereas few report on apoptosis and its regulatory pathways. Apoptosis can be induced and controlled by a variety of cytokines (18).…”

Gastroparesis

“…Autoimmunity is a key feature in the pathogenesis of type 1 diabetes, but may also be involved in type 2 diabetes as shown by the presence of autoantibodies. Singla et al [16] report antiglutamic acid decarboxylase but no antiislet cell or antiinsulin antibodies in six (five type 1 diabetes) out of 16 diabetic gastroparesis patients (12 with type 1 diabetes). There was no association with severity of symptoms or delay in gastric emptying, suggesting, therefore, that autoantibodies are probably not key factors in the pathogenesis of diabetic gastroparesis.…”

Diabetic Gastroparesis: Principles and Current Trends in Management

“…mean acceleration of 20%) and shortened the lag time (mean reduction of 34%) relative to placebo. TZP-101 also reduced overall post-meal symptom intensity (24%) and postprandial fullness (37%) [ 33 ]. However, because of limited efficacy this drug is no longer in clinical trials.…”

“…It was also noted that patients with type 1 diabetes with DGp reported profound neuropathy, more anxiety and less reduction in symptom scores with intervention compared to those with type 2 diabetics with DGp [ 32 ]. Interestingly autoantibody (GAD 65) prevalence in both type 1(40%) and type 2 (25%) diabetes did not predict the severity of gastroparesis [ 33 ].…”