β-Cell Function in Relation to Islet Cell Antibodies During the First 3 Yr After Clinical Diagnosis of Diabetes in Type II Diabetic Patients

Gottsäter, Anders; Landin‐Olsson, Mona; Fernlund, Per; Lernmark, Åke; Sundkvist, Göran

doi:10.2337/diacare.16.6.902

Cited by 117 publications

(77 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…10 Of interest is 1 study showing that fasting C-peptide levels in ICA-positive patients with type 2 diabetes were similar to patients with type 1 diabetes, 3 years after diagnosis. 20 In the present study, the higher incidence of ␤-cell antibodies in adolescents with type 2 diabetes (Table 2) supports the previously reported correlation of positive diabetes antibodies with younger age at diagnosis. 8 Our data also suggest that ICA antibody positivity at diagnosis could be a predictor of future insulin need.…”

Section: Discussionsupporting

confidence: 81%

Diabetic Autoimmune Markers in Children and Adolescents With Type 2 Diabetes

et al. 2001

View full text Add to dashboard Cite

ABSTRACT.Background. There is an increase in the incidence of type 2 diabetes in children and adolescents. Absence of known diabetes autoimmune markers is sometimes required to confirm the diagnosis.Objective. To identify clinical and autoimmune characteristics of type 2 diabetes in a pediatric population.Method. We report an analysis of 48 children and adolescents with type 2 diabetes, compared with 39 randomly selected children with type 1 diabetes, diagnosed and followed at the Loma Linda University Pediatric Diabetes Center. Ethnic, familial, seasonal, and autoimmune marker characteristics are outlined. To determine the reliability of antibody testing in confirming the type of diabetes at diagnosis, we studied the incidence of positive islet cell antibodies (ICAs), glutamic acid decarboxylase antibodies (GADs), and insulin autoantibodies (IAAs) at diagnosis in both groups. ICA512, GADs, and IAAs were measured by radioimmunoassay.Results. The cohort with type 2 diabetes had a similar gender distribution as the group with type 1 diabetes but a significantly higher age at diagnosis. Ethnic background was significantly different between the 2 groups, predominantly Hispanic in type 2 and white in type 1. Body mass index was significantly higher in type 2 diabetes (mean ‫؍‬ 31.24 kg/m 2 ). Among the patients with type 2 diabetes, 33% presented in diabetic ketoacidosis, random blood glucose at diagnosis ranged from 11.4 to 22.25 mmol/L (228 -445 mg/dL), fasting C-peptide levels ranged from 0.89 to 2.7 nmol/L (2.7-8.2 ng/mL; normal: <1.36 nmol/L), and hemoglobin A 1C was 10.8 ؎ 3.5% (normal: <6.6%). None of these parameters was significantly different from the type 1 diabetes group. Although the incidence of diabetes antibody markers was significantly lower in type 2 versus type 1 diabetes, 8.1% of patients with type 2 diabetes had positive ICAs, 30.3% had positive GADs, and 34.8% had positive IAAs without ever being treated with insulin. In the type 2 diabetes group, none of the Hispanic patients had ICAs. However, there was no significant correlation between any of the diabetes antibodies and obesity, presence of acanthosis nigricans, or family history of diabetes. The frequency of thyroid antibodies was not significantly different from the group with type 1 diabetes. Daily insulin requirements 1 year after diagnosis were significantly lower in type 2 diabetes, ranging from 0 to 1.2 U/kg with a mean of 0.33. Conclusion.Absence of diabetes autoimmune markers is not a prerequisite for the diagnosis of type 2 diabetes in children and adolescents. Pediatrics 2001;107(6). URL: http://www.pediatrics.org/cgi/content/full/107/6/ e102; type 2 diabetes, adolescents, autoimmunity, islet cell antibodies, glutamic acid decarboxylase antibodies.

show abstract

Section: Discussionsupporting

confidence: 81%

Diabetic Autoimmune Markers in Children and Adolescents With Type 2 Diabetes

et al. 2001

View full text Add to dashboard Cite

show abstract

“…All new consecutively diagnosed adult diabetic patients (>15 years of age, n=233) between September 1985 and August 1987 in the city of Malmö, Sweden, were included in this prospective study [4,[13][14][15][16]. The diabetes definition based on fasting plasma glucose ≥7.8 mmol/l or a 2 hr plasma glucose after oral glucose tolerance test (OGTT) ≥11.1 mmol/l was used and 13% of all diabetes patients were clinically considered to have type 1 diabetes, 62% type 2 diabetes and 6% were classified as suspected type 2 diabetes but with islet antibodies.…”

Section: Patientsmentioning

confidence: 99%

“…In addition, we wanted to evaluate whether presence of antibodies at diagnosis has any implication for diabetes complications, mortality and causes of death. To our knowledge, the present study is the only non-interventional 20 year follow-up study of the clinical course of diabetes in a total material of consecutively diagnosed adult onset diabetic patients [13].…”

Section: Introductionmentioning

confidence: 98%

No signs of progressive beta cell damage during 20 years of prospective follow-up of autoantibody-negative diabetes

et al. 2011

View full text Add to dashboard Cite

Aims Both type 1 (T1D) and type 2 (T2D) diabetes are considered to be associated with different degrees of progressive beta cell damage. However, few long term studies have been made. Our aim was to study the clinical course of 20 years of diabetes disease, including diabetes progression, co-morbidity and mortality in a prospectively studied cohort of consecutively diagnosed diabetic patients.Methods Among all 233 patients diagnosed with diabetes during 1985-1987 in Malmö, Sweden, 50 of 118 surviving patients were followed-up after 20 years. The age at diagnose was 42.323.1 and 57.513.6 yrs for antibody positive and antibody negative patients, respectively. HbA1c and plasma lipids were analysed with regard to metabolic control.Results Islet antibody negative patients at diagnosis had highly preserved C-peptide levels after 20 years in contrast to antibody positive patients (antibody-negative: C-peptide 0yrs 0.780.47 and 20yrs 0.700.46 (nmol/l), p=0.51 and antibody-positive: C-peptide 0yrs 0.330.35 and 20yrs 0.100.18; p<0.001. Islet antibodies but not age, BMI or C-peptide at diagnosis were predictors of C-peptide levels at 20 years when analysed by logistic regression (p<0.05). HbA1c did not differ between the groups after 20 years. The 20-year mortality was higher among antibody-negative patients, dependent on the higher age at diagnosis in this group (number of deaths: antibody-positive: 18 of 56 vs. antibody-negative: 109 of 188, p<0.001). Of the deceased, 79 % had died from diseases or complications that may be associated to diabetes. ConclusionWe found no progressive beta cell damage in autoantibody negative diabetes at a 20 year follow-up of the clinical course of diabetes.

show abstract

“…This leaves little scope for therapies which stimulate insulin secretion or make the body more sensitive to its actions, effective though these are in insulin-resistant individuals with a larger functioning beta cell mass. The interval between diagnosis and insulin therapy will be shorter in those with lower C-peptide [7], but this is because they have fewer beta cells and does not necessarily mean they have a more aggressive form of disease.…”

Section: Drawing Lines In the Sandmentioning

confidence: 99%