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Diabetes-related auto-antibody test?

2012-09-19 17:12

What is Diabetes-related auto-antibody test?

Diabetes-related auto-antibody testing is primarily ordered to distinguish between autoimmune type 1 Diabetes and Diabetes due to other causes. Type 1 Diabetes, once referred to Juvenile Diabetes, is a condition characterized by a lack of insulin due to an autoimmune process which destroys pancreatic insulin-producing beta cells. Clinically, when such typical symptoms of Diabetes as frequent urination, thirst and weight loss occur, about 80-90% percent of the beta cells have been destroyed by autoimmune attack so that they will no longer be able to produce insulin. The body requires daily insulin so that glucose can enter cells and be used for energy production. Without sufficient insulin, cells starve and high blood glucose will occur. Acute hyperglycemia may cause severe medical crisis and chronic high blood sugar can damage blood vessels in eyes, foot, kidneys, heart, etc.

Diabetes-related auto-antibody tests are performed to reflect the destruction of beta cells, the loss of beta cell function, and inadequate production of insulin that are features of type 1 diabetes. Early diagnosing Type 1 Diabetes allows for early treatment and the most effective therapy to prevent further destruction to beta cells, slow down progression of Diabetes and avoid complications of Diabetes.

How is Diabetes auto-antibody testing performed?

Four kinds of auto-antibodies are most commonly used to distinguish Type 1 Diabetes and Diabetes due to other causes:

1. Islet cell cytoplasmic auto-antibodies, or ICA, is one of the most commonly detected islet beta cell auto-antibodies at onset of type 1 Diabetes. It is seen in about 70-80 cases of newly diagnosed Type 1 DM.

2. GADA, or Glutamic Acid Decarboxylase Autoantibodies. The antibodies are directed to beta cell protein but are not specific to beta cells. GADA is detected in 70-80% cases of newly diagnosed type 1 Diabetics

3. Insulinoma Associated-2 autoantibodies, or IA2A. The test measures auto-antibodies which target beta cell antigens. Positivity of IA2A is seen in 60% of type 1 Diabetes

4. Insulin autoantibodies, or IAA. IAA antibody targets at insulin, which is the only antigen highly specific for beta cells. It’s seen in about 50% cases of Type 1 Diabetes, but not commonly detected in adults

The auto-antibodies detected in children are different from those in children. IAA positivity is usually the first maker to be seen in Children. As the condition progresses, IAA may disappear and other antibodies including IAA, GADA and IA-2A will be more obviously detected. IA-2A is less common at initial onset of the disease in comparison to GADA or ICA. About 50 percent children are detected IAA at initial onset, but IAA positivity in adults is much less common.

Diabetes antibody test results

Diagnosis of Diabetes can be confirmed if ICA, GADA and IA-2A antibodies are detected. Similarly, a child who is detected IAA but is not treated by insulin can also be diagnosed as Type 1 Diabetes.

It is unlikely that Diabetes is the cause if no Diabetes-related auto-antibodies are detected. Most people, over 95%, have at least one islet antibody when they are newly diagnosed as Type 1 Diabetes. In some rare cases, a person with Type 1 Diabetes may don’t have any detectable auto-antibodies.

What else do I need to know?

Ant-antibody testing will distinguish Type 1 Diabetes from Diabetes due to other causes. In addition, islet auto-antibody testing is also an effective tool to predict the development of type 1 Diabetes in family members of those affected. The more islet auto-antibodies are detected in a non-diabetic, the higher risk a person has in getting Type 1 Diabetes. A possible immune blocking approach may hold promise in controlling the autoimmune destruction to beta cells and preventing progression of insulin-producing beta cell loss.

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