Youths With Type 2 Diabetes Show Autoimmunity Evidence

Islet autoantibody analysis may help distinguish type 2 diabetes and autoimmune diabetes
By Beth Gilbert
HealthDay Reporter

MONDAY, Sept. 20 (HealthDay News) -- There may be evidence of islet autoimmunity contributing to insulin deficiency in obese youths with type 2 diabetes, and clinical characteristics may be significantly different between those with and without diabetes autoantibody (DAA) positivity, according to a study published in the September issue of Diabetes Care.

Georgeanna J. Klingensmith, M.D., of the University of Colorado Denver in Aurora, and colleagues evaluated 1,206 children, aged 10 to 17 years, diagnosed with type 2 diabetes to determine the presence of GAD-65 and/or insulinoma-associated protein 2 autoantibodies.

The investigators found that 9.8 percent of children were antibody positive, with 5.9 percent positive for a single antibody and 3.9 percent positive for both antibodies. Compared to patients who were DAA negative, those who were DAA positive were more likely to be white (40.7 versus 19 percent) and male (51.7 versus 35.7 percent). In terms of clinical findings, the median body mass index (BMI) and BMI z scores were significantly lower among those who were DAA positive. DAA-positive patients were less likely to present with clinical characteristics typically linked to type 2 diabetes and metabolic syndrome, including increases in blood pressure and triglycerides and low high-density lipoprotein cholesterol.

"As a group, patients with DAA have clinical characteristics significantly different from those without DAA. However, without islet autoantibody analysis, these characteristics cannot reliably distinguish between obese young individuals with type 2 diabetes and those with autoimmune diabetes," the authors write.

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