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Glutamic acid decar...
Glutamic acid decarboxylase antibodies (GADA) is the most important factor for prediction of insulin therapy within 3 years in young adult diabetic patients not classified as Type 1 diabetes on clinical grounds
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- Törn, Carina (author)
- Skåne University Hospital
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- Landin-Olsson, Mona (author)
- Skåne University Hospital
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- Östman, Jan (author)
- Karolinska University Hospital
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- Scherstén, Bengt (author)
- Lund University,Lunds universitet,Allmänmedicin och samhällsmedicin,Forskargrupper vid Lunds universitet,Family Medicine and Community Medicine,Lund University Research Groups
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- Arnqvist, Hans, 1943- (author)
- Östergötlands Läns Landsting,Linköpings universitet,Linköping University,Hälsouniversitetet,Cellbiologi,GE: endomed
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- Blohmé, Göran (author)
- Stockholm South General Hospital
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- Björk, Elisabeth (author)
- Uppsala University Hospital
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- Bolinder, Jan (author)
- Karolinska Institutet
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- Eriksson, Jan (author)
- Norrland University Hospital
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- Littorin, Bengt (author)
- Lund University,Lunds universitet,Allmänmedicin och samhällsmedicin,Forskargrupper vid Lunds universitet,Family Medicine and Community Medicine,Lund University Research Groups
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- Nyström, Lennarth (author)
- Umeå University
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- Sundkvist, Göran (author)
- Skåne University Hospital
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- Lernmark, Åke (author)
- University of Washington
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(creator_code:org_t)
- 2000
- 2000
- English 6 s.
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In: Diabetes/Metabolism Research and Reviews. - 1520-7552 .- 1520-7560. ; 16:6, s. 442-447
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Abstract
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- Background Differentiation between Type 1 and Type 2 diabetes in adults is difficult at diagnosis. In this study we tested the hypothesis that autoantibodies at diagnosis are predictive for insulin treatment within 3 years in patients initially not classified as Type 1 diabetes. Methods In a nationwide population-based study, blood samples were obtained from 764 patients, all diagnosed with diabetes during a 2-year period. At diagnosis, 583 (76%) were classified as Type 1, 110 (14%) as Type 2 and 71 (9.3%) could not be classified. Results Among patients not classified as Type 1 diabetes, 52 (47%) of Type 2 and 42 (59%) of unclassified patients were positive for islet cell antibodies CICA), glutamic acid decarboxylase antibodies (GADA) or tyrosine phosphatase antibodies (IA-2A). These patients (n=94) had lower body mass index (BMI) (p<0.001) and lower C-peptide (p<0.001) compared to the autoantibody negative patients (n=87). Compared to clinically classified Type 1 diabetes patients positive for autoantibodies (n=477), they have higher BMI (p<0.001), higher C-peptide (p<0.001) and the same levels of ICA, GADA and IA-2A. After 3 years, 93% of autoantibody positive patients initially not classified as Type 1 were on insulin. When ICA, GADA, IA-2A, BMI and C-peptide were tested in a multiple logistic regression, only GADA was signiificant for insulin treatment within 3 years (OR = 18.8; 95% CI 1.8-191) in patients treated with diet or oral drugs at diagnosis. Conclusions A correct classification is difficult in adult diabetic patients. The presence of pancreatic autoantibodies, especially GADA, at diagnosis of diabetes are highly predictive for insulin therapy within 3 years from diagnosis.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Endokrinologi och diabetes (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Endocrinology and Diabetes (hsv//eng)
Keyword
- Body mass index (BMI)
- C-peptide
- Diabetes classification
- GADA
- IA-2A
- ICA
- MEDICINE
Publication and Content Type
- art (subject category)
- ref (subject category)
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- By the author/editor
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Törn, Carina
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Landin-Olsson, M ...
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Östman, Jan
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Scherstén, Bengt
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Arnqvist, Hans, ...
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Blohmé, Göran
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show more...
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Björk, Elisabeth
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Bolinder, Jan
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Eriksson, Jan
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Littorin, Bengt
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Nyström, Lennart ...
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Sundkvist, Göran
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Lernmark, Åke
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show less...
- About the subject
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
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and Endocrinology an ...
- Articles in the publication
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Diabetes/Metabol ...
- By the university
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Lund University
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Karolinska Institutet
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Linköping University