Rapid Normalization of High Glutamic Acid Decarboxylase Autoantibody Titers and Preserved Endogenous Insulin Secretion in a Patient with Diabetes Mellitus: A Case Report and Literature Review

Intern Med. 2016;55(5):485-9. doi: 10.2169/internalmedicine.55.5398. Epub 2016 Mar 1.

Abstract

A 59-year-old Japanese woman developed diabetes mellitus without ketoacidosis in the presence of glutamic acid decarboxylase autoantibody (GADA) (24.7 U/mL). After the amelioration of her hyperglycemia, the patient had a relatively preserved serum C-peptide level. Her endogenous insulin secretion capacity remained almost unchanged during 5 years of insulin therapy. The patient's GADA titers normalized within 15 months. The islet-related autoantibodies, including GADA, are believed to be produced following the autoimmune destruction of pancreatic beta cells and are predictive markers of type 1 diabetes mellitus. Therefore, the transient appearance of GADA in our patient may have reflected pancreatic autoimmune processes that terminated without progression to insulin deficiency.

Publication types

  • Case Reports

MeSH terms

  • Autoantibodies / blood*
  • Biomarkers / blood
  • C-Peptide / blood*
  • Diabetes Mellitus, Type 1 / blood*
  • Diabetes Mellitus, Type 1 / drug therapy
  • Disease Progression
  • Female
  • Glutamate Decarboxylase / blood*
  • Glutamate Decarboxylase / drug effects
  • Humans
  • Hyperglycemia / drug therapy
  • Hypoglycemic Agents / therapeutic use
  • Insulin / metabolism*
  • Insulin / therapeutic use
  • Insulin Secretion
  • Middle Aged
  • Pancreas / drug effects
  • Pancreas / metabolism*
  • Predictive Value of Tests
  • Treatment Outcome

Substances

  • Autoantibodies
  • Biomarkers
  • C-Peptide
  • Hypoglycemic Agents
  • Insulin
  • Glutamate Decarboxylase