PREVALENCE OF GAD AND IA2 ANTIBODIES IN CLINICALLY DIAGNOSED YOUNG INDIAN TYPE 2 DIABETES INDIVIDUALS WITH AGE OF ONSET OF DIABETES LESS THAN 35 YEARS

Dr. R. Anil Kumar*

ABSTRACT

Objectives: To determine the prevalence of GAD 65 and insulinoma associated protein 2 auto antibodies in clinically diagnosed type 2 diabetes with age of onset less than 35 years. Materials and methods: 381 patients were randomly selected from patients with age of onset of diabetes less than 35 years attending the outpatient department of Karnataka institute of endocrinology and research Bangalore over a period of 2 years. A fasting and post prandial blood sample was taken for estimation of plasma glucose by hexokinase method. HBA1C was measured by the high-performance liquid chromatography method using the Bio-rad Variant 2 turbo analyzer. Diagnosis of diabetes was made by using criteria of fasting plasma glucose ≥126 mg/dl and HBA1c ≥6.5%. GAD 65 and IA 2 antibodies were estimated using ELISA methods. Results: Age of onset of all type 2 diabetes subjects is less than 35 years. 34.6% and 60.6% of the subjects were in the age group of 20 to 30 and 31-40 years, 72.4% were males. Newly diagnosed subjects were 17.3%, duration of diabetes 1 to 5 years in 63.8% and 6 to 10 years in 14.2% of type 2 diabetes subjects. Consanguinity was present in 26.2% of subjects. BMI was 18.5 to 24.9 in 54.3% and 25 to 29.9 in 38.1% of subjects. Antibody positivity was detected in 29 (7.61%) of 381 subjects studied. GAD antibody positive in 22 (6.04%), IA 2 antibody positive in 5(1.3%) and 2(.52%) were positive for both antibodies in clinically diagnosed type 2 diabetes subjects. The clinical variables of age, BMI, waist circumference, hip circumference SBP, DBP, FPG, PPPG, HBA1C and fasting C-peptide were statistically similar between antibody positive and negative groups studied. Conclusions: Antibody positivity was detected in 29 (7.61%) of 381 subjects studied. GAD antibody positive in 22 (6.04%), IA 2 antibody positive in 5(1.3%) and 2(.52%) were positive for both antibodies in clinically diagnosed type 2 diabetes subjects. So if we test GAD antibodies in Indian type 2 diabetes subjects we can detect many LADA patients. It is not necessary to test other antibodies which will save lot of money when we do a large population or clinic based multicentre studies. Immunomodulator therapy in antibody positive type 2 diabetes subjects may help to reduce beta call destruction.

Keywords: GAD antibodies, IA2 antibodies, C-Peptide.