Progression to insulin deficiency in Korean patients with Type 2 diabetes mellitus positive for anti-GAD antibody

Diabet Med. 2011 Mar;28(3):319-24. doi: 10.1111/j.1464-5491.2010.03186.x.

Abstract

Aims: To investigate the rate of progression to insulin deficiency in Korean patients with Type 2 diabetes mellitus positive for anti-GAD antibody (GADA) and to determine the factors related to progression to insulin deficiency.

Methods: We retrospectively analysed data on 87 GADA-positive and 87 age- and sex-matched GADA-negative patients with Type 2 diabetes. GADA-positive patients were further subclassified into high-titre (≥ 250 WHO units/ml) (n = 24) and low-titre (< 250 WHO units/ml) (n = 63) subgroups. Cox proportional hazard analysis was used to identify factors associated with progression to insulin deficiency.

Results: Over a period of 6 years, two of 87 (2.3%) GADA-negative and 37 of 87 (42.5%) GADA-positive patients had progressed to insulin deficiency. The rate of progression to insulin deficiency was higher in the high-titre than in the low-titre subgroup (75.0 vs. 30.2%). Multivariate analysis in GADA-positive patients showed that high-titre GADA and low BMI at diagnosis were independent factors significantly related to progression to insulin deficiency.

Conclusions: The presence of GADA predicted the progression to insulin deficiency in Korean patients with Type 2 diabetes. In GADA-positive patients, high-titre GADA and low BMI were associated with this progression.

MeSH terms

  • Asian People*
  • Autoantibodies / analysis*
  • Diabetes Mellitus, Type 1 / blood
  • Diabetes Mellitus, Type 1 / immunology*
  • Diabetes Mellitus, Type 1 / physiopathology
  • Diabetes Mellitus, Type 2 / blood
  • Diabetes Mellitus, Type 2 / immunology*
  • Diabetes Mellitus, Type 2 / physiopathology
  • Disease Progression
  • Female
  • Humans
  • Islets of Langerhans / immunology*
  • Male
  • Middle Aged
  • Proportional Hazards Models
  • Retrospective Studies

Substances

  • Autoantibodies