Evaluating the Prognostic Value of Islet Autoantibody Monitoring in Islet Transplant Recipients with Long-Standing Type 1 Diabetes Mellitus

(1) Background: The correlation between titers of islet autoantibodies (IAbs) and the loss of transplanted islets remains controversial. We sought to evaluate the prognostic utility of monitoring IAbs in diabetic patients after islet transplantation (ITx); (2) Methods: Twelve patients with Type 1 diabetes mellitus and severe hypoglycemia underwent ITx. Serum concentration of glutamic acid decarboxylase (GAD), insulinoma antigen 2 (IA-2), and zinc transport 8 (ZnT8) autoantibodies was assessed before ITx and 0, 7, and 75 days and every 3 months post-operatively; (3) Results: IA-2A (IA-2 antibody) and ZnT8A (ZnT8 antibody) levels were not detectable before or after ITx in all patients (median follow-up of 53 months (range 24–61)). Prior to ITx, GAD antibody (GADA) was undetectable in 67% (8/12) of patients. Of those, 75% (6/8) converted to GADA+ after ITx. In 67% (4/6) of patients with GADA+ seroconversion, GADA level peaked within 3 months after ITx and subsequently declined. All patients with GADA+ seroconversion maintained long-term partial or complete islet function (insulin independence) after 1 or 2 ITx. There was no correlation between the presence of IAb-associated HLA haplotypes and the presence of IAbs before or after ITx; (4) Conclusions: There is no association between serum GADA trends and ITx outcomes. IA-2A and ZnT8A were not detectable in any of our patients before or after ITx.

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MECHANISMS IN ENDOCRINOLOGY: Seizures and type 1 diabetes mellitus: current state of knowledge

Acta Endocrinologica ◽

10.1530/eje-12-0699 ◽

2012 ◽

Vol 167 (6) ◽

pp. 749-758 ◽

Cited By ~ 29

Author(s):

Alberto Verrotti ◽

Alessandra Scaparrotta ◽

Cristina Olivieri ◽

Francesco Chiarelli

Keyword(s):

Diabetes Mellitus ◽

Type 1 Diabetes ◽

Type 1 Diabetes Mellitus ◽

Neurological Diseases ◽

Underlying Mechanism ◽

Acid Decarboxylase ◽

Diabetic Patients ◽

Current State ◽

Metabolic Conditions

In this review, we will try to analyze the possible coexistence between epilepsy or seizures and type 1 diabetes mellitus (T1DM), in order to establish if there is more than a casual association, and to investigate possible mechanisms underlying this link. Anti-glutamic acid decarboxylase antibodies (GAD-Abs) have been associated with T1DM and a great number of neurological diseases such as epilepsy. Epilepsy can be a feature of a large variety of autoimmune or inflammatory disorders. GAD-Abs can have a role at the basis of the possible link between epilepsy and T1DM, although their real pathogenetic mechanism in neurological diseases is still unknown. Metabolic conditions such as hypoglycemia and hyperglycemia, common problems in diabetic patients, may be also implicated, even if their underlying mechanism is minimally understood.

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Short and long-term glycemic variability associated with severe hypoglycemia and retinopathy in type 1 diabetes mellitus

Endocrine Abstracts ◽

10.1530/endoabs.70.aep520 ◽

2020 ◽

Author(s):

Martín Borja Sanz ◽

Gimeno Sergio Roman ◽

Peteiro Miranda Carlos Miguel ◽

Ortez Toro Jose Jorge ◽

Ana Agudo ◽

...

Keyword(s):

Diabetes Mellitus ◽

Type 1 Diabetes ◽

Type 1 Diabetes Mellitus ◽

Severe Hypoglycemia ◽

Glycemic Variability ◽

Short And Long Term

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Autoimmune thyroid disease in patients with anti-GAD positive type 1 diabetes mellitus

Open Medicine ◽

10.2478/s11536-009-0080-z ◽

2009 ◽

Vol 4 (4) ◽

pp. 415-422

Author(s):

Kamile Gul ◽

Ihsan Ustun ◽

Yusuf Aydin ◽

Dilek Berker ◽

Halil Erol ◽

...

Keyword(s):

Diabetes Mellitus ◽

Type 1 Diabetes ◽

Type 1 Diabetes Mellitus ◽

Statistical Significance ◽

Control Group ◽

Acid Decarboxylase ◽

Thyroid Peroxidase ◽

The Difference ◽

Type 1 Dm

AbstractThe aim of the study was to determine the frequency and titers of anti-thyroid peroxidase (Anti-TPO), anti-thyroglobulin (Anti-TG), and anti-glutamic acid decarboxylase (Anti-GAD) antibodies in Turkish patients with type 1 diabetes mellitus (DM), and to compare the frequency of anti-TPO and anti-TG titers in the presence or absence of anti-GAD. A total of 104 patients including 56 males and 48 females with type 1 DM and their age-, gender-, and body mass index-matched control group, including 31 males and 27 females, 58 cases in total with an age range of 15-50 years, were recruited into this study. In patients with type 1 DM, positive anti-GAD was detected in 30.8% (n=32). In patients with positive anti-GAD, rate of positive anti-TPO was 37.5%; however, in patients with negative anti-GAD, the rate of positive anti-TPO was 9.7% and the difference was statistically significant (p=0.001). In patients with positive anti-GAD, the rate of positive anti-TG was 18.8%. In patients with negative anti-GAD, the rate of positive anti-TG was 2.8%, and the difference between them was statistically significant (p=0.005). In patients with positive and negative anti-GAD, rates of both positive anti-TPO and anti-TG were 15.6% and 1.4%, respectively, with the difference showing statistical significance (p=0.004). Thyroid autoimmunity in type 1 DM patients with positive anti-GAD was apparently higher; therefore, these patients should be followed more frequently and carefully.

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Proinsulinoma causing severe hypoglycemia in a patient with type 1 diabetes mellitus

Case Reports in Clinical Pathology ◽

10.5430/crcp.v1n2p21 ◽

2014 ◽

Vol 1 (2) ◽

Cited By ~ 3

Author(s):

Leonard A. Bertheau ◽

Robert C. Herceg ◽

Ramiro Malgor ◽

Aili Guo ◽

Frank Lee Schwartz

Keyword(s):

Diabetes Mellitus ◽

Type 1 Diabetes ◽

Type 1 Diabetes Mellitus ◽

Severe Hypoglycemia

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Interleukin-12p40 gene (IL-12B) polymorphism and Type 1 diabetes mellitus in Japanese: Possible role in subjects without having high-risk HLA haplotypes

Diabetes Research and Clinical Practice ◽

10.1016/j.diabres.2005.05.005 ◽

2006 ◽

Vol 71 (2) ◽

pp. 164-169 ◽

Cited By ~ 15

Author(s):

Jian Mei Yang ◽

Shoichiro Nagasaka ◽

Toshimitsu Yatagai ◽

Tomoatsu Nakamura ◽

Ikuyo Kusaka ◽

...

Keyword(s):

Diabetes Mellitus ◽

Type 1 Diabetes ◽

High Risk ◽

Type 1 Diabetes Mellitus ◽

Hla Haplotypes

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Molecular-genetic, immunological bases and prophylaxis of diabetes mellitus in children

Problems of Endocrinology ◽

10.14341/probl20115719-18 ◽

2011 ◽

Vol 57 (1) ◽

pp. 9-18

Author(s):

E V Titovich

Keyword(s):

Diabetes Mellitus ◽

Type 1 Diabetes ◽

Type 1 Diabetes Mellitus ◽

Molecular Genetic ◽

Clinical Manifestations ◽

Russian Population ◽

Research Centre ◽

Diabetic Patients ◽

Genetic Studies

Since the autoimmune nature of type 1 diabetes mellitus came to become known some 40 years ago, continuous investigations have been carried out in an attempt to improve approaches to prognostication of this disease and develop new safe and efficacious methods for its prevention. For all that, many aspects of diabetes pathogenesis still remain far from clear. In most cases (roughly 85%), type 1 diabetes mellitus (DM1) develops sporadically in the absence of a relevant familial or hereditary history of this condition. Accordingly, the first-degree relatives account for only 15% of all DM1 patients. The risk of development of DM1 in the Russian population estimated by the researchers of the Children' Department, Endocrinological Research Centre, is relatively low (0.2%). It depends on many factors, such as the number of ill and healthy relatives, the chronological age of a given patient and the age of onset of clinical manifestations in his (her) relatives. Type 1 diabetes-predisposing and protective haplotypes were identified in the Russian population based on the results of molecular-genetic studies involving 599 children and adolescents with DM1. These and immunological data were used to distinguish between risk groups in the families of diabetic patients and the rationale was proposed for the dynamic follow-up of these subjects. It is concluded that estimation of the risk of type 1 diabetes mellitus based on the results of molecular-genetic studies and monitoring immunological markers constitutes the first step in the elaboration of preventive measures designed to prevent or delay the development of the disease.

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ALLERGIC DISEASES IN TYPE 1 DIABETIC PATIENTS: A BRIEF REVIEW

Romanian Journal of Infectious Diseases ◽

10.37897/rjid.2015.2-3.3 ◽

2015 ◽

Vol 18 (2-3) ◽

pp. 65-71

Author(s):

Alina Gabriela Dutu ◽

◽

Silviu Albu ◽

Keyword(s):

Diabetes Mellitus ◽

Type 1 Diabetes ◽

Autoimmune Disease ◽

Type 1 Diabetes Mellitus ◽

Allergic Diseases ◽

Developed Countries ◽

Diabetic Patients ◽

Inverse Association ◽

Stepping Stones

Type 1 diabetes mellitus is considered an autoimmune disease mediated by Th1 lymphocytes, while allergic diseases are characterized by Th2-mediated immune response. Their incidence is rising in developed countries and the interaction between autoimmune and atopic diseases has been a subject of interest for decades. There are many controversies about the association or mutual exclusion of these diseases, but classical paradigm based on the assumption that diseases mediated by Th1 and Th2 should be mutually exclusive, has been revised considering both the role of regulatory T cells Threg, and the environmental factors involved. The aim of this review is to investigate the association of allergic diseases (rhinitis, asthma, dermatitis) in patient diagnosed with type 1 diabetes mellitus. The studies that attempted to shed light on this topic had surprisingly varied results. These ranged from statistically significant proof of an inverse association between an autoimmune disease and one or several atopic ones to other implying positive associations. Although up to now studies on this subject present seemingly discordant results, each attempt raises new questions and sheds light on new factors involved in the interaction of these diseases. They present much needed stepping stones for future studies to learn from and adapt.

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Association between urinary N-acetyl-beta-glucosaminidase and its isoenzyme patterns and microangiopathy in type 1 diabetes mellitus

Clinical Chemistry ◽

10.1093/clinchem/37.10.1696 ◽

1991 ◽

Vol 37 (10) ◽

pp. 1696-1699 ◽

Cited By ~ 14

Author(s):

C D Agardh ◽

E Agardh ◽

A Isaksson ◽

B Hultberg

Keyword(s):

Diabetes Mellitus ◽

Type 1 Diabetes ◽

Type 1 Diabetes Mellitus ◽

Metabolic Control ◽

Isoenzyme Pattern ◽

Diabetic Patients ◽

Type 1 Diabetic Patients ◽

Isoenzyme Patterns ◽

Apparently Healthy

Abstract Urinary N-acetyl-beta-glucosaminidase (NAG) and its isoenzymes (NAG A and NAG B) in samples from 87 type 1 diabetic patients and 40 apparently healthy reference subjects were studied with enzyme immunoassays. The diabetic patients had higher concentrations of urinary NAG than did the control subjects (P less than 0.01), but the isoenzyme pattern did not differ. There was a positive correlation between metabolic control (Hb A1c concentrations) and total NAG (P less than 0.01), NAG A (P less than 0.01), and NAG B (P less than 0.001). The diabetic patients were divided into three groups, depending on the degree of retinopathy. Subjects with severe forms of retinopathy did not have increased concentrations of urinary NAG unless they had concomitant nephropathy. The isoenzyme pattern was similar irrespective of degree of retinopathy or nephropathy. The results indicate that concentrations of urinary NAG are positively correlated to the degree of nephropathy, whereas there is no such correlation to the degree of retinopathy.

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