Antibodies to glutamic acid decarboxylase in Japanese diabetic patients with secondary failure of oral hypoglycaemic therapy

Diabet Med. 1997 Feb;14(2):148-52. doi: 10.1002/(SICI)1096-9136(199702)14:2<148::AID-DIA317>3.0.CO;2-9.

Abstract

Some patients with non-insulin-dependent (Type 2) diabetes mellitus (NIDDM) are positive for antibodies to glutamic acid decarboxylase (anti-GAD), which have been shown to be a useful marker for the diagnosis and prediction of insulin-dependent (Type 1) diabetes mellitus (IDDM). Anti-GAD positive NIDDM patients tend to develop insulin deficiency. We investigated the prevalence of anti-GAD in 200 NIDDM with secondary failure of oral hypoglycaemic therapy (SF) and 200 NIDDM well controlled by diet and/or sulphonylurea agents (NSF). Twenty-two of 200 (11%, p < 0.05) SF patients and 6 of 200 (3%) NSF patients were anti-GAD positive. The positive. The positive rate for anti-GAD was as high as 23.8% in the non-obese and insulin deficient SF patients. The SF patients with anti-GAD tended to be non-obese and to have an impaired release of endogenous insulin. The internal before development of secondary failure was not associated with the presence of anti-GAD in this study. In conclusion we found that anti-GAD was positive in as many as 11% of the SF patients, suggesting that autoimmune mechanisms may play an important role in the pathogenesis of secondary failure or sulphonylurea therapy.

MeSH terms

  • Analysis of Variance
  • Antibodies / analysis
  • Antibodies / chemistry
  • Autoantibodies* / analysis
  • Body Mass Index
  • C-Peptide / blood
  • Diabetes Mellitus, Type 2 / drug therapy
  • Diabetes Mellitus, Type 2 / immunology*
  • Fasting / blood
  • Female
  • Glutamate Decarboxylase / immunology*
  • Humans
  • Hypoglycemia / therapy*
  • Insulin / administration & dosage
  • Japan
  • Male
  • Middle Aged
  • Obesity / immunology
  • Time Factors
  • Treatment Failure*
  • Urine / chemistry

Substances

  • Antibodies
  • Autoantibodies
  • C-Peptide
  • Insulin
  • Glutamate Decarboxylase