Poor Beta-cell Function After the Clinical Manifestation of Type 1 Diabetes in Children Initially Positive for Islet Cell Specific Autoantibodies

• Published in: Diabetic medicine Vol. 14; no. 7; pp. 532 - 537
• Main Authors: Komulainen, J., Knip, M., Lounamaa, R., Vähäsalo, P., Karjalainen, J., Sabbah, E., Åkerblom, H.K.
• Format: Journal Article
• Language: English
• Published: Chichester, UK John Wiley & Sons, Ltd 01.07.1997; Blackwell
• Subjects: Biological and medical sciences; Functional investigation of endocrine glands and genital system; glutamic acid decarboxylase antibodies; insulin autoantibodies; insulin dose; Investigative techniques, diagnostic techniques (general aspects); islet cell antibodies; Medical sciences; metabolic control; serum C-peptide; type 1 diabetes; Endocrinopathy; Pancreatic hormone; Replacement therapy; Cell function; Autoimmune disease; Lyases; Acid base balance disorder; Endocrine secretion; Protein hormone; B-Cell; Immunological investigation; Carboxy-lyases; Predictive value; Endocrine pancreas; Human; Immunopathology; Antibody; Enzyme; Langerhans islet; Autoantibody; Glutamate decarboxylase; Insulin; Carbon-carbon lyases; Metabolic disorder; Ketoacidosis; Insulin dependent diabetes; Effective dose
• ISSN: 0742-3071; 1096-9136; 1464-5491
• DOI: 10.1002/(SICI)1096-9136(199707)14:7<532::AID-DIA403>3.0.CO;2-6

The prognostic significance of islet cell specific autoantibodies at the diagnosis of Type 1 (insulin‐dependent) diabetes mellitus for the persistence of residual beta‐cell function over the first 2 years of clinical disease was evaluated in a prospective population‐based study. Seven hundred and eighty probands, aged 0.8–14.9 years, were examined for islet cell antibodies (ICA) and insulin autoantibodies (IAA), while 769 probands were studied for antibodies to glutamic acid decarboxylase (GAD65A). They were subsequently observed for 2 years. Lower serum C‐peptide concentrations and higher requirement of exogenous insulin during the follow‐up period were observed in the group of probands positive for at least one of the antibodies, especially for ICA or IAA. We conclude that the residual beta‐cell function after the presentation of Type 1 diabetes is less in children initially positive for islet cell specific autoantibodies than in those testing negative at diagnosis. This might reflect possible heterogeneity in the pathogenesis of childhood diabetes. It also demonstrates that ICA and IAA negativity at the diagnosis of Type 1 diabetes is not associated with a smaller amount of functioning beta‐cell mass, but the absence of antibodies probably reflects a slower beta‐cell destructive process and a longer duration of preclinical disease. © 1997 John Wiley & Sons, Ltd.