Autoantibodies in diabetes mellitus

Author: Prof. Dr. med. Peter Altmeyer

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Last updated on: 29.10.2020

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Antibodies in diabetes mellitus; Diabetes antibodies; Diabetes mellitus Autoantibodies

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The determination of autoantibodies plays a central role in the differentiation of diabetes mellitus, especially in the differentiation between type 1 and type 2 diabetes and between LADA and type 1/2 diabetes.

The most important antibodies in type 1 diabetes are:

The heterogeneously composed family of cytoplasmic islet cell antibodies (ICA) are often the first to be detected in the manifestation phase of type 1 diabetes in adolescents (prevalence 60-90%). However, their value is now increasingly underestimated compared to other beta-cell antibodies. For LADA, the occurrence of antibodies against GAD65 is diagnostically most meaningful. These also occur in older patients with a high prevalence (approx. 80%) and remain detectable in the course of diabetes for longer than any other beta cell antibody. Therefore they can confirm autoimmune diabetes even years after the onset of the disease.

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GAD65 autoantibodies have the greatest importance for the screening and differential diagnosis of LADA and type 2 diabetes. Positive findings prove the presence of an autoimmune process, negative GADA findings exclude an autoimmunological etiology with a high probability. In case of negative findings, other antibodies against islet cells or insulin can be determined additionally to improve sensitivity. Their occurrence is partly age-dependent. IA-2 antibodies against tyrosine phosphatase in the islet cell membrane are more likely to be found in young patients. Insulin antibodies are used to assess the risk of developing diabetes in young children. Their determination under insulin therapy is not very useful, as it is then not possible to differentiate between antibodies against exogenous or endogenous insulin.

ZnT8-Ak show a good (negative) correlation with the mass and residual function of beta cells and can be detected without another diabetes-specific autoantibody reacting positively (25-30% of cases). The additional determination of ZnT8-Ak increases the overall sensitivity of antibody diagnostics in type 1 diabetes to > 90%.

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The occurrence of diabetes-specific autoantibodies can be detected already during the symptom-free development phase of autoimmune diabetes. A general screening, e.g. of school children, does not make sense, since no effective measures can be taken to prevent the disease.

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Outgoing links (5)

Anti-znt8 antibodies; Gada; Ia-2-ac; Iaa; Ica;


Last updated on: 29.10.2020