Author: Prof. Dr. med. Peter Altmeyer

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Last updated on: 21.12.2021

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Insulin-Ak; Insulin Autoantibodies; Insulin Car-Ac

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Antibodies against insulin(IAA) can develop as a result of insulin therapy with exogenous insulin or in the context of autoimmunological diabetes mellitus (type 1 diabetes). IAA occur in direct dependence on age in up to 90% of patients. The younger the patients are at the time of manifestation of type 1 diabetes, the more likely it is that IAA will be detected.

Important: Insulin antibodies are usually the first autoantibodies to be detected and can often be detected several years before the clinical manifestation of type 1 diabetes mellitus. Thus, they play an important role in the risk assessment of the development of diabetes in young children.

General information
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IA-2-Ak are directed against an islet cell membrane protein (ICA512, tyrosine phosphatase IA-2). At 60-80%, IA-2-Ak are slightly less frequently positive for type 1 diabetes than islet cell or GAD65 antibodies. In first diabetic patients, IA-2 antibodies are positive in 60-70% of type 1 diabetics and in 2-5% of first-degree relatives. Of these antibody carriers, 65% develop diabetes mellitus within 5 years.

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The detection of IA2 antibody is performed by an enzyme linked immunosorbent assay (ELISA) using recombinant human tyrosine phosphatase (IA2) for its quantitative and qualitative determination.

Sample volume: > 75 µL serum

Reference range: < 10 IU/ml

Material: 1 ml serum

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The determination of insulin Ac is not advisable under insulin therapy, as it is not possible to differentiate between induced insulin antibodies and autoimmune insulin Ac.

Prevalences at initial diagnosis: 100 % (children < 5 years); 90 % (children/adolescents < 17 years); < 20 % (adults > 17 years). Several studies have shown that the occurrence of IAA can reduce the risk of diabetes in relatives1 . In several studies it was shown that the occurrence of IAA significantly increased the risk of diabetes in relatives1. degree of diabetics: 37% of the persons with both antibodies (IAA positive/ICA positive) developed a manifest type 1 diabetes within the follow-up, in contrast to 14% (ICA positive/IAA negative) and 16% (ICA negative/IAA positive) with only one positive autoantibody.


Last updated on: 21.12.2021