GAD autoantibodies in a selection-free population of insulin-treated diabetic patients: indicator of a high prevalence of LADA?

Diabetes Res Clin Pract. 2000 Jul;49(1):33-40. doi: 10.1016/s0168-8227(00)00139-x.

Abstract

Up to the present only few data have been available concerning the prevalence of diabetes-specific autoantibodies (anti-GAD, ICA, IAA, IA-2) in unselected populations, in particular in type 2 diabetic patients. Hence, the aim of the present study was to determine the prevalence of anti-GAD in a selection-free population of insulin-treated diabetic patients. Accordingly, 90% of all the insulin-treated diabetic patients (type 1, n=127, type 2, n=117) aged 16-60 years and living in the city of Jena (100242 inhabitants) were examined. In order to test sera for anti-GAD, serum samples were taken in 75% of type 1 (n=95) and in 80% of insulin-treated type 2 diabetic (n=94) patients.

Results: In the group of type 1 diabetic patients 55% of the patients tested were positive for anti-GAD. But, interestingly, in the type 2 group, a total of 21% patients were positive. With respect to this high percentage of anti-GAD positive type 2 diabetic patients it must be suggested that the frequency of patients with latent autoimmune diabetes mellitus in adults (LADA) was underestimated in the past.

MeSH terms

  • Adolescent
  • Adult
  • Antibodies, Monoclonal
  • Autoantibodies / blood*
  • Chromatography, High Pressure Liquid
  • Diabetes Mellitus, Type 1 / complications
  • Diabetes Mellitus, Type 1 / epidemiology*
  • Diabetes Mellitus, Type 1 / immunology
  • Diabetes Mellitus, Type 2 / complications
  • Diabetes Mellitus, Type 2 / epidemiology*
  • Diabetes Mellitus, Type 2 / immunology
  • Diabetic Nephropathies / complications
  • Diabetic Nephropathies / diagnosis
  • Diabetic Neuropathies / complications
  • Diabetic Neuropathies / diagnosis
  • Diabetic Retinopathy / complications
  • Diabetic Retinopathy / diagnosis
  • Female
  • Germany / epidemiology
  • Glutamate Decarboxylase / immunology*
  • Glycated Hemoglobin A / analysis
  • Humans
  • Insulin / therapeutic use
  • Kidney Diseases / complications
  • Kidney Diseases / diagnosis
  • Male
  • Middle Aged
  • Nervous System Diseases / complications
  • Nervous System Diseases / diagnosis
  • Prevalence
  • Radioimmunoassay
  • Retinal Diseases / complications
  • Retinal Diseases / diagnosis
  • Seroepidemiologic Studies

Substances

  • Antibodies, Monoclonal
  • Autoantibodies
  • Glycated Hemoglobin A
  • Insulin
  • Glutamate Decarboxylase