open access

Vol 8, No 2 (2019)
ORIGINAL ARTICLES
Published online: 2019-04-04
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Changing profile of GAD and IA-2 antibody positivity in Indian children with recently diagnosed type 1 diabetes mellitus

Debmalya Sanyal, Sandip K Batabyal, Subrata Maity, Sudip Chatterjee
DOI: 10.5603/DK.2019.0005
·
Clinical Diabetology 2019;8(2):116-120.

open access

Vol 8, No 2 (2019)
ORIGINAL ARTICLES
Published online: 2019-04-04

Abstract

Introduction. Published literature on type 1 diabetes (T1DM) patients from India suggests that a substantial number of them are negative to GAD 65 and IA-2 an­tibodies. Antibody positivity rates have been linked to dietary and socio-economic factors and more recently, to changes in the enterobiome. Our anecdotal evidence indicated that antibody positivity rates among newly diagnosed T1DM children were rising. In this presen­tation we have formally collated our data on these antibodies, a first, we believe, in the Indian pediatric population. Material and methods. T1DM was diagnosed by stand­ard clinical criteria advocated by American Diabetes Association including in all patients, the presence of diabetic ketoacidosis (DKA). We used plasma blood glucose rather than A1C to diagnose the acute onset of type 1 diabetes in individuals with symptoms of hy­perglycemia. All patients with this diagnosis had GAD (glutamic acid decarboxylase) and IA-2 (insulinoma antigen 2) antibodies measured as a routine procedure from 2007. Data on patients between the ages of 1 and 16 years as on 31st August 2016 were collected for this study. The antibodies were measured by standard RIA kits from the same manufacturer and performed in the endocrinology laboratory of one of the institutions. Results. We included 694 T1DM cases from 2007 till 2016, out of which 296 were antibody positive. A total of 172 were GAD antibody positive, 62 were IA-2 anti­body positive and 90 exhibited dual antibody positivity (GAD positive + IA-2 positive). The chi-square test for trend analysis showed a significant rising trend for IA-2 antibody alone positive (p < 0.001, chi-square for trend = 17.437, df = 1) and either antibody positive percentages (p < 0.001, chi-square for trend = 22.71, df = 1), but not in the GAD antibody positivity (p = 0.059, chi-square for trend = 3.567, df = 1) and in dual antibody positive percentages (p = 0.486, chi-square for trend = 0.485, df = 1) over a period of 9 years i.e. from 2007 to 2016. Conclusion. Antibody positivity rates in recently di­agnosed T1DM children have changed fairly rapidly over the last nine years. This surge in autoimmunity may also be a significant contributing factor towards the recent increased incidence of T1DM in India.

Abstract

Introduction. Published literature on type 1 diabetes (T1DM) patients from India suggests that a substantial number of them are negative to GAD 65 and IA-2 an­tibodies. Antibody positivity rates have been linked to dietary and socio-economic factors and more recently, to changes in the enterobiome. Our anecdotal evidence indicated that antibody positivity rates among newly diagnosed T1DM children were rising. In this presen­tation we have formally collated our data on these antibodies, a first, we believe, in the Indian pediatric population. Material and methods. T1DM was diagnosed by stand­ard clinical criteria advocated by American Diabetes Association including in all patients, the presence of diabetic ketoacidosis (DKA). We used plasma blood glucose rather than A1C to diagnose the acute onset of type 1 diabetes in individuals with symptoms of hy­perglycemia. All patients with this diagnosis had GAD (glutamic acid decarboxylase) and IA-2 (insulinoma antigen 2) antibodies measured as a routine procedure from 2007. Data on patients between the ages of 1 and 16 years as on 31st August 2016 were collected for this study. The antibodies were measured by standard RIA kits from the same manufacturer and performed in the endocrinology laboratory of one of the institutions. Results. We included 694 T1DM cases from 2007 till 2016, out of which 296 were antibody positive. A total of 172 were GAD antibody positive, 62 were IA-2 anti­body positive and 90 exhibited dual antibody positivity (GAD positive + IA-2 positive). The chi-square test for trend analysis showed a significant rising trend for IA-2 antibody alone positive (p < 0.001, chi-square for trend = 17.437, df = 1) and either antibody positive percentages (p < 0.001, chi-square for trend = 22.71, df = 1), but not in the GAD antibody positivity (p = 0.059, chi-square for trend = 3.567, df = 1) and in dual antibody positive percentages (p = 0.486, chi-square for trend = 0.485, df = 1) over a period of 9 years i.e. from 2007 to 2016. Conclusion. Antibody positivity rates in recently di­agnosed T1DM children have changed fairly rapidly over the last nine years. This surge in autoimmunity may also be a significant contributing factor towards the recent increased incidence of T1DM in India.

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Keywords

type 1 diabetes mellitus, autoantibody, children, India

About this article
Title

Changing profile of GAD and IA-2 antibody positivity in Indian children with recently diagnosed type 1 diabetes mellitus

Journal

Clinical Diabetology

Issue

Vol 8, No 2 (2019)

Pages

116-120

Published online

2019-04-04

DOI

10.5603/DK.2019.0005

Bibliographic record

Clinical Diabetology 2019;8(2):116-120.

Keywords

type 1 diabetes mellitus
autoantibody
children
India

Authors

Debmalya Sanyal
Sandip K Batabyal
Subrata Maity
Sudip Chatterjee

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